þ | ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
o | TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
Puerto Rico | 66-0555678 | |
(STATE OF INCORPORATION) | (I.R.S. ID) |
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Triple-S, Inc. (TSI), a health insurance company serving two major segments: the
Commercial Program and the Commonwealth of Puerto Rico Health Reform Program (the Reform);
Seguros Triple-S, Inc. (STS), a property and casualty insurance company; and
Seguros de Vida Triple-S, Inc. (SVTS), a life and disability insurance and annuity products company.
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TSIs accumulated statutory net income while operating under the tax exemption,
amounting to $132.8 million, was deemed distributed to TSM.
For tax purposes, TSM recognized the exempt accumulated statutory net income as gross
income. On this amount, TSM recognized an income tax liability amounting to $51.8
million, which was determined by applying a tax rate of 39% to the exempt accumulated
statutory net income deemed distributed to TSM. This income tax liability was recorded by
TSM within the current income tax expense in the 2003 consolidated statements of earnings.
Of this tax $37.0 million were paid on July 31, 2003, the date of the closing agreement,
and $14.8 million on April 15, 2004.
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initiatives to increase healthcare regulation, including efforts to expand the tort liability of health plans,
local government plans and initiatives, and
Medicare reform legislation.
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Disruption of on-going business operations, distraction of management, diversion of
resources and difficulty in maintaining current business standards, controls and
procedures.
Difficulty in integrating information technology of acquired entity and unanticipated
expenses related to such integration.
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Difficulty in the integration of the new companys accounting, financial reporting,
management, information, human resources and other administrative systems and the lack of
control if such integration is delayed or not implemented.
Difficulty in the implementation of controls, procedures and policies appropriate for
filers with the Securities and Exchange Commission at companies that prior to acquisition
lacked such controls, policies and procedures.
Potential unknown liabilities associated with the acquired company or under-estimating know liabilities.
Failure of acquired business to achieve anticipated revenues, earnings or cash flow.
Incurrence of additional debt related to future acquisitions.
Competition with other entities, some of which may have greater financial and other
resources, to acquire attractive companies.
(a)
As of December 31, 2005, the Corporation is a defendant in various lawsuits arising in
the ordinary course of business. Management believes, based on the opinion of legal
counsel, that the aggregate liabilities, if any, arising from such actions would not have
a material adverse effect on the Corporations consolidated financial position or results
of operations.
(b)
Drs. Carlyle Benavent and Ibrahim Pérez (the plaintiffs) caused the initiation of an
administrative proceeding before the Puerto Rico Insurance Commissioner against TSI and
TSM alleging the illegality of the repurchase and subsequent sale of 1,582 shares of TSIs
common stock due to the fact that the ultimate purchasers of said shares were selected on
an improper and selective basis by the Corporation in violation of the Puerto Rico
Insurance Code. The plaintiffs alleged that they were illegally excluded from
participation in the sale of shares by TSI due to the illegally selective nature of the
sale of shares and that, consequently, the sale of shares should be eliminated.
In December 1996, the Commissioner of Insurance issued an order to annul the sale of the
1,582 shares that TSI had repurchased from the estate of deceased stockholders. TSI
contested such order through an administrative and judicial review process. Consequently,
the sale of 1,582 shares was cancelled and the purchase price was returned to each former
stockholder. In the year 2000, the Commissioner of Insurance issued a pronouncement
providing further clarification of the content and effect of the order. This order also
required that all corporate decisions undertaken by TSI through the vote of its
stockholders of record, be ratified in a stockholders meeting or in a subsequent
referendum. In November 2000, TSM, as the sole stockholder of TSI, ratified all such
decisions. Furthermore, on November 19, 2000, TSM held a special
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stockholders meeting, where a ratification of these decisions was undertaken except for
the resolution related to the approval of the reorganization of TSI and its subsidiaries.
This resolution did not reach the two thirds majority required by the order because the
number of shares that were present and represented at the meeting was below such amount
(total shares present and represented in the stockholders meeting was 64%). As stipulated
in the order, TSM began the process to conduct a referendum among its stockholders in order
to ratify such resolution. The process was later suspended because upon further review of
the scope of the order, the Commissioner of Insurance issued an opinion in a letter dated
January 8, 2002 which indicated that the ratification of the corporate reorganization was
not required.
In another letter dated March 14, 2002, the Commissioner of Insurance stated that the
ratification of the corporate reorganization was not required and that TSI had complied
with the Commissioners order of December 6, 1996 related to the corporate reorganization.
Thereafter, the plaintiffs filed a petition for review of the Commissioners determination
before the Puerto Rico Circuit Court of Appeals. Such petition was opposed by TSI and by
the Commissioner of Insurance.
Pursuant to that review, on September 24, 2002, the Puerto Rico Circuit Court of Appeals
issued an order requiring the Commissioner of Insurance to order that a meeting of
shareholders be held to ratify TSIs corporate reorganization and the change of name of TSI
from Seguros de Servicios de Salud de Puerto Rico, Inc. to Triple-S, Inc. The Puerto Rico
Circuit Court of Appeals based its decision on administrative and procedural issues
directed at the Commissioner of Insurance. The Commissioner of Insurance filed a motion of
reconsideration with the Puerto Rico Circuit Court of Appeals on October 11, 2002. TSM and
TSI also filed a motion of reconsideration.
On October 25, 2002, the Puerto Rico Circuit Court of Appeals dismissed the Commissioner of
Insurances Motion for Reconsideration and ordered the plaintiffs to reply to TSIs Motion
of Reconsideration.
On May 18, 2003, the Puerto Rico Circuit Court of Appeals granted TSIs and TSMs Motion of
Reconsideration. The Puerto Rico Circuit Court of Appeals held that the Commissioner of
Insurance had the authority to waive the celebration of a referendum to ratify TSIs
reorganization and that therefore the reorganization of TSI, inasmuch as the 1,582 shares
annulled were not decisive, was approved by the stockholders.
On June 26, 2003, the plaintiffs presented a writ of certiorari before the Supreme Court of
Puerto Rico. TSI and TSM filed a motion opposing the issuance of the writ. The writ was
issued by the Supreme Court on August 22, 2003 when it ordered the Puerto Rico Circuit
Court of Appeals to transmit the record of the case. On December 1, 2003, the plaintiffs
filed a motion submitting their case on the basis of their original petition. TSI and TSM
filed its brief on December 30, 2003, while the Commissioner of Insurance, in turn, filed a
separate brief on December 31, 2003. On June 24, 2004 the Supreme Court of Puerto Rico
ordered the plaintiffs to file a brief in support of their allegations. The case is still
pending before the Supreme Court of Puerto Rico. It is the opinion of the management and
its legal counsels that the corporate reorganization as approved is in full force and
effect.
(c)
On September 4, 2003, José Sánchez and others filed a putative class action complaint
against the Corporation, present and former directors of TSM and TSI, and others, in the
United States District Court for the District of Puerto Rico, alleging violations under
the Racketeer Influenced and Corrupt Organizations Act, better known as the RICO Act. The
suit, among other allegations, alleges a scheme to defraud the plaintiffs by acquiring
control of TSI through illegally capitalizing TSI and later converting it to a for-profit
corporation and depriving the stockholders of their ownership rights. The plaintiffs base
their later allegations on the supposed decisions of TSIs board of directors and
stockholders, allegedly made in 1979, to operate with certain restrictions in order to
turn TSI into a charitable corporation, basically forever. On March 4, 2005 the Court
issued an Opinion and Order. In this Opinion and Order, of the twelve counts included in
the complaint, eight counts were dismissed for failing to assert an actionable injury; six
of them for lack of standing and two for failing to plead with sufficient particularity in
compliance with the Rules. All shareholder allegations, including those described above,
were dismissed in the Opinion and Order. The remaining four counts were found standing,
in a limited way, in the Opinion and Order. Finally, the Court ordered that by March 24,
2005 one of the counts left standing be replead to conform to the Rules and that by March
28, 2005 a proposed schedule for discovery and other submissions be filed. The count was
amended and accepted by the Court and the discovery schedule was submitted. The parties
have finished class certification discovery. The parties fully briefed the issue of class
certification and are awaiting the Courts decision. In addition, the defendants are
evaluating the dismissal of the surviving claims. This case is still pending before the
United States District Court for the District of Puerto Rico.
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(d)
On April 24, 2002, Octavio Jordán, Agripino Lugo, Ramón Vidal, and others filed a
suit against TSM, TSI and others in the Court of First Instance for San Juan, Superior
Section, alleging, among other things, violations by the defendants of provisions of the
Puerto Rico Insurance Code, anti-monopolistic practices, unfair business practices and
damages in the amount of $12.0 million. They also requested that TSM sell shares to them.
After a preliminary review of the complaint, it appears that many of the allegations
brought by the plaintiffs have been resolved in favor of TSM and TSI in previous cases
brought by the same plaintiffs in the United States District Court for the District of
Puerto Rico and by most of the plaintiffs in the local courts. The defendants, including
TSM and TSI answered the complaint, filed a counterclaim and filed several motions to
dismiss this claim. On February 18, 2005 the plaintiffs informed their intention to amend
the complaint and the Court granted them 45 days to do so and 90 days to the defendants to
file the corresponding motion to dismiss. On May 9, 2005 the plaintiffs amended the
complaint and the defendants are preparing the corresponding motions to dismiss this
amended complaint. The plaintiffs amended the complaint to allege causes of action
similar to those dismissed by the United States District Court for the District of Puerto
Rico in the Sánchez case. Defendants moved to dismiss the amended complaint. Plaintiffs
have notified their opposition to some of the defendants motion to dismiss, and the
defendants filed the corresponding replies. On January 25, 2006, the court held a hearing
to argue the dispositive motions.
(e)
On May 22, 2003 a putative class action suit was filed by Kenneth A. Thomas, M.D. and
Michael Kutell, M.D., on behalf of themselves and all others similarly situated and the
Connecticut State Medical Society against the Blue Cross and Blue Shield Association
(BCBSA) and multiple other insurance companies including TSI. The case is pending before
the U.S. District Court for the Southern District of Florida, Miami District.
The individual plaintiffs bring this action on behalf of themselves and a class of
similarly situated physicians seeking redress for alleged illegal acts of the defendants,
which they allege have resulted in a loss of their property and a detriment to their
business, and for declaratory and injunctive relief to end those practices and prevent
further losses. Plaintiffs alleged that the defendants, on their own and as part of a
common scheme, systematically deny, delay and diminish the payments due to doctors so that
they are not paid in a timely manner for the covered, medically necessary services they
render.
The class action complaint alleges that the health care plans are the agents of BCBSA
licensed entities, and as such have committed the acts alleged above and acted within the
scope of their agency, with the consent, permission, authorization and knowledge of the
others, and in furtherance of both their interest and the interests of other defendants.
Management believes that TSI was brought to this litigation for the sole reason of being
associated with the BCBSA. However, on June 18, 2004 the plaintiffs moved to amend the
complaint to include the Colegio de Médicos y Cirujanos de Puerto Rico (a compulsory
association grouping all physicians in Puerto Rico), Marissel Velázquez, MD, President of
the Colegio de Médicos y Cirujanos de Puerto Rico, and Andrés Meléndez, MD, as plaintiffs
against TSI. Later Marissel Velázquez, MD voluntarily dismissed her complaint against TSI.
TSI, along with the other defendants, moved to dismiss the complaint on multiple grounds,
including but not limited to arbitration and applicability of the McCarran Ferguson Act.
The Court issued a 90-day stay to allow the parties to discuss their differences and come
to amicable agreement. The stay expired on March 7, 2006. Upon the expiration of the
stay, both plaintiffs and defendants agreed to request the Court to extend the stay until
April 21, 2006.
(f)
On December 8, 2003 a putative class action was filed by Jeffrey Solomon, MD and
Orlando Armstrong, MD, on behalf of themselves and all other similarly situated and the
American Podiatric Medical Association, Florida Chiropractic Association, California
Podiatric Medical Association, Florida Podiatric Medical Association, Texas Podiatric
Medical Association, and Independent Chiropractic Physicians, against the BCBSA and
multiple other insurance companies, including TSI and all members of the BCBSA. The case
is still pending before the United States District Court for the Southern District of
Florida, Miami District.
The lawsuit challenges many of the same practices as the litigation described in the
immediately preceding item.
Management believes that TSI was made a party to this litigation for the sole reason that
TSI is associated with the BCBSA.
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On June 25, 2004, plaintiffs amended the complaint but the allegations against TSI did not
vary. TSI along with the other defendants, moved to dismiss the complaint on multiple
grounds, including but not limited to arbitration and applicability of the McCarran
Ferguson Act.
The Court issued a 90-day stay to allow the parties to discuss their differences and come
to an amicable agreement. The stay expired on March 7, 2006. Although the parties are
still in the process of discussing their differences, they have not moved the Court to
extend the stay. The defendants suggested that plaintiffs join in a request to extend the
stay, but the plaintiffs have not reacted to the defendants invitation.
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(Dollar amounts in thousands, except per share data)
2005
2004
2003
2002
2001
$
1,380,204
1,298,959
1,264,395
1,236,647
1,155,399
210,905
179,166
160,127
150,684
134,374
(196,460
)
(169,924
)
(151,806
)
(141,138
)
(126,295
)
1,394,649
1,308,201
1,272,716
1,246,193
1,163,478
29,029
26,499
24,679
24,778
25,405
7,161
10,968
8,365
185
4,655
(4,709
)
3,042
14,893
(8,322
)
(3,625
)
3,732
3,360
4,703
2,075
483
$
1,429,862
1,352,070
1,325,356
1,264,909
1,190,396
$
28,433
45,803
26,229
48,249
21,715
$
3,193
5,135
2,857
1,085
1,052
$
1,137,462
919,657
834,623
721,892
656,058
$
150,590
95,730
48,375
50,015
55,650
$
308,703
301,433
254,255
231,664
186,028
(1)
Further details of the calculation of basic earnings per share are set forth in notes 2 and 22 of the audited
consolidated financial statements for the years ended December 31, 2005, 2004 and 2003.
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(Dollar amounts in thousands)
2005
2004
2003
$
779,913
720,789
699,365
510,839
484,742
477,614
86,767
86,228
78,334
17,130
16,442
17,403
$
1,394,649
1,308,201
1,272,716
$
1,208,367
1,115,793
1,065,350
181,703
171,879
165,149
$
1,390,070
1,287,672
1,230,499
86.6
%
85.3
%
83.7
%
13.0
%
13.1
%
13.0
%
99.6
%
98.4
%
96.7
%
$
29,029
26,499
24,679
7,161
10,968
8,365
(4,709
)
3,042
14,893
$
31,481
40,509
47,937
$
3,764
14,014
65,397
$
15,384
23,757
49,071
(43
)
9,250
14,034
9,863
11,085
9,677
2,098
996
3,716
1,131
715
(50,269
)
$
28,433
45,803
26,229
The premiums earned, net and fee revenue corresponding to the Health Insurance
Commercial Program presented an increase of $59.1 million, or 8.2%, during this period.
The increase in premiums earned, net of this segment is due to a 1.2% increase in average
enrollment together with a 6.0% increase in average premium rates in 2005.
The premiums earned, net of the Health Insurance Reform segment presented an increase
of $26.1 million, or 5.4%, in 2005, as compared to the premiums earned, net in 2004. This
increase is the result of a 4.5% increase in average premium rates together with a 0.9%
increase in the average membership of the segment.
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During 2005, the claims incurred of the Health Insurance Commercial segment increase
of $57.1 million, or 9.2%, is primarily attributed to an increase in utilization and costs
of services as well as to an increase in average enrollment.
The claims incurred of the Health Insurance Reform segment increased $40.2 million, or
9.2%, when comparing the amounts incurred in the years 2005 and 2004. The increase in the
claims incurred of this segment results mostly from higher utilization trends and costs,
particularly in the risks assumed by the segment, such as cardiovascular services,
dialysis and obstetrics and HIV, among others. In addition, this segment also experienced
an increase in claims incurred that is attributed to the increase in its average
enrollment.
The premiums earned, net and fee revenue corresponding to the Health Insurance
Commercial Program increased $21.4 million, or 3.1%, during this period. The increase in
premiums earned, net of this segment is due to increases in premium rates and an increase
in the average enrollment of Self-funded Employers accounts.
The premiums earned of the property and casualty insurance segment increased by $7.9
million, or 10.1%, during the year 2004. This increase is mostly the result of the
segments increased volume of business, particularly in the Dwelling and Auto Physical
Damage lines of business.
The premiums earned, net of the Health Insurance Reform segment increased $7.1
million, or 1.5%, in 2004, as compared to the premiums earned, net in 2003. The increase
in the premiums earned, net of this segment is due to increases in premium rates during
the contract renegotiation process, net of a decrease in membership.
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(Dollar amounts in thousands)
2005
2004
2003
305,362
302,634
305,100
152,194
141,009
128,803
86,628
84,807
84,407
49,244
51,917
53,993
34,910
40,257
43,177
628,338
620,624
615,480
$
768,672
714,442
693,645
211,975
180,216
161,014
(196,460
)
(169,924
)
(151,806
)
$
784,187
724,734
702,853
$
677,870
620,751
584,448
103,562
94,930
92,264
$
781,432
715,681
676,712
$
2,755
9,053
26,141
86.4
%
85.7
%
83.2
%
13.2
%
13.1
%
13.1
%
99.6
%
98.8
%
96.3
%
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Premiums for the segments Medicare Advantage program, which was launched in the year
2005, amounted to $34.2 million. No Medicare Advantage premiums were reflected in the
2004 period.
In 2005, the segments average enrollment increased 7,714 members, or 1.2%, when
compared to the year 2004. The increase in the average enrollment is mostly reflected in
the self-funded employers and corporate accounts businesses, which membership increased by
11,185, or 7.9%, and 2,728, or 0.9%, during this period, respectively. This increase in
average enrollment is mostly attributed to new groups acquired throughout 2005. The
average enrollment of the local government employees and Federal employees businesses, on
the other hand, decreased by 5,347, or 13.3%, and 2,673, or 5.1%, during this year,
respectively.
On average, this segment increased premium rates by approximately 6% during the year
2005.
The segment constantly monitors claims trends, particularly in the rated corporate
accounts and Individual lines of business. This practice assures adequate premium rates
that reflect the actual claims trend of each particular business. On average, this
segment increased premium rates by 4.5% during the year 2004.
The increase in total average enrollment of 5,144 members, or 0.8%, during the year
2004 when compared to 2003 is mainly the result of flat employment levels in Puerto Rico
during the last three years. The most significant increase in enrollment is in the
Self-funded Employers, which presents an increase of 12,206 members, or 9.5%, since during
this period certain large corporate accounts groups shifted from the rated business to
self-funded arrangements, assuming the risk associated with insuring their employees. The
increase experienced in this business is mitigated by the decrease experienced in 2004 in
the Local government employees and Federal employees businesses, which present a decrease
of 2,920 members, or 6.8%, and 2,076, or 3.8%, respectively.
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The business growth experienced in 2004 resulted in an increase of $2.3 million in
payroll expenses and commissions due to agents and brokers.
The increase in technology related expenses of $1.5 million is directly related to the
segments commitment to continuously enhance services to its members and service
providers.
During 2004, the segment experienced an increase in legal expenses of $1.3 million and
an increase in professional services and consulting fees of $1.5 million mostly as a
result of assistance related to legal, governmental and regulatory matters related to its
business.
All of these increases in 2004 were offset by a reduction in pension expense due to
non-recurring pension settlements of $4.6 million in 2003, resulting from the number of
retirees selecting lump-sum benefits instead of annuities.
(Dollar amounts in thousands)
2005
2004
2003
235,738
232,956
236,766
220,517
217,441
224,903
163,807
164,357
168,109
620,062
614,754
629,778
$
510,839
484,742
477,614
$
478,008
437,834
428,045
36,432
35,777
34,637
$
514,440
473,611
462,682
$
(3,601
)
11,131
14,932
93.6
%
90.3
%
89.6
%
7.1
%
7.4
%
7.3
%
100.7
%
97.7
%
96.9
%
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Premium rates for this segment were increased, effective August 1
st
, 2005,
by approximately 5.8% during the Healthcare Reform contract renegotiation process for the
eleven-month period ending June 30, 2006. In addition, premium rates were increased by
approximately 4.4% for the thirteen-month period ended July 31, 2005. On average the
increase in premium rates during 2005 was 4.5%.
The average enrollment for this segment increased by 5,308 members, or 0.9%, when
comparing the 2005 and 2004 periods.
During the Reform contract renegotiation process, premium rates were increased by
approximately 4.4% and 4.2% for the twelve-month periods ended June 30, 2005 and June 30,
2004, respectively. On average the increase in premium rates during 2004 was 4.4%.
The average enrollment for this segment decreased by 15,024 members, or 2.4%, during
the year 2004. This decrease is attributed to the continuous review and screening
performed by the Government of Puerto Rico over the lists of persons eligible to
participate in the Reform.
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(Dollar amounts in thousands)
2005
2004
2003
$
65,649
56,506
54,986
26,094
28,323
22,624
20,690
18,922
15,821
14,520
14,082
12,753
8,541
8,485
6,522
6,504
6,499
5,986
9,129
9,057
9,435
151,127
141,874
128,127
(59,244
)
(52,215
)
(43,771
)
(5,116
)
(3,431
)
(6,022
)
$
86,767
86,228
78,334
$
43,587
45,977
43,390
39,642
40,182
37,354
$
83,229
86,159
80,744
$
3,538
69
(2,410
)
50.2
%
53.3
%
55.4
%
45.7
%
46.6
%
47.7
%
95.9
%
99.9
%
103.1
%
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In 2004, the segment experienced increased costs for catastrophe coverage as well as
the need to compensate for the coverage increase in the property business.
The amount of premiums ceded in the 2003 period was reduced as a result of the
cancellation of the property surplus treaty. This cancellation resulted in a reinsurance
portfolio transfer resulting in net incoming business and a reduction in the amount of
premiums ceded.
During 2003 the segment increased its retention in the personal lines quota share
treaty from 70% to 95%. In addition, as a result of the increased retention, the segment
received an incoming reinsurance portfolio transfer causing a reduction in the premiums
ceded in the 2003 period.
The effect of an increase in commission expense due to the segments increased volume
of business
During 2004, the segment recorded a guaranty fund assessment to cover liabilities of
insolvent companies. This assessment, which amounted to $871 thousand, was charged to
operations during 2004.
The experience refund received from the Compulsory Vehicle Liability Insurance Joint
Underwriting Association increased by $202 thousand, from $633 thousand during 2003 to
$840 thousand during 2004. This refund is recorded as a decrease to the operating
expenses for the period.
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(Dollar amounts in thousands)
2005
2004
2003
$
13,681
13,392
14,115
8,768
10,138
10,588
1,746
179
24,195
23,709
24,703
(8,006
)
(7,966
)
(7,816
)
400
16,589
15,743
16,887
541
699
516
$
17,130
16,442
17,403
$
8,902
11,231
9,467
8,201
7,347
6,036
$
17,103
18,578
15,503
$
27
(2,136
)
1,900
52.0
%
68.3
%
54.4
%
47.9
%
44.7
%
34.7
%
99.9
%
113.0
%
89.1
%
The earned premiums of the cancer and other dreaded diseases line of business increased
by $1.6 million during the year 2005. This fluctuation is attributed to an increase in
the average certificates in force of this business by 8,221 during this year. This line
of business was introduced during the latter part of the year 2004.
The earned premiums of the group life line of business decreased by $1.4 million, or
13.5%, during the year 2005. This fluctuation is attributed to the loss of one major
group in the group life business, effective December 31, 2004. This particular group had
annualized premiums of $1.4 million and an average loss ratio of 92.0%. The segment is
closely monitoring claims experience and considering this experience upon each groups
renewal process. This practice has resulted in the loss during the renewal process of
several groups with higher than expected claims experience once the premiums were adjusted
to reflect actual claims experience.
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The earned premiums of the group disability line of business decreased by $723
thousand, or 5.1%, during the year 2004. This decrease is mostly attributed to the fact
that during the first quarter of 2003, the segment revised its methodology for estimating
the premiums of its short-term disability business. This revision resulted in a
non-recurring adjustment increasing earned premiums of this line of business by
approximately $1.1 million during the year 2003. The average certificates in force of the
group disability line of business increased by 3,996 certificates, or 2.3%, during the
year 2004.
The earned premiums of the group life line of business decreased by $450 thousand, or
4.3%, during the 2004 period is attributed to a decrease in the average certificates in
force of 9,802, or 6.6%. This decrease is attributed to the loss of several groups with
higher than expected claims experience since the segment is closely monitoring claims
experience and considering this experience upon each groups renewal process.
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Increase in collections of premiums of $86.2 million in 2005 and $35.3 million in 2004.
The increase in premium collections is the result of the increased premium rates and
increased volume of business of the operating segments.
Increase of $75.5 million in 2005 and $13.2 million in 2004 in the amount of cash paid
to suppliers and employees. This increase is principally attributed to the initial ceding
commission of $60.0 million paid by SVTS to GA Life on the effective date of the
coinsurance funds withheld agreement (described in Item 1. Business of this Annual
Report on Form 10-K in the section corresponding to the Life and Disability Insurance
segment). The initial ceding commission was recorded by the Corporation within the
deferred policy acquisition costs. Also, the Corporation has incurred additional
commission expense generated from the acquisition of new business and general operating
expenses.
Increase of $100.7 million and $26.3 million in 2005 and 2004, respectively, in the
amount of claims losses and benefits paid. In both years the increase in the amount of
claims losses and benefits paid is mostly the result of the segments increased volume of
business as well as to increased utilization trends in both Health Insurance segments.
Decrease in income taxes paid of $35.6 million in 2005 and an increase in income taxes
paid of $5.4 million in 2004. The decrease in the amount of income taxes paid in 2005 is
mostly due to the fact that the 2004 period includes the payment of $14.8 million of the
last installment of the $51.8 million income tax liability related to the closing
agreement with the PRTD upon the termination of TSIs tax exemption. In addition, on
April 15, 2004 TSI paid $22.1 million corresponding to its income tax liability for the
year 2003 and the first installment of the estimated tax corresponding to the year 2004.
In the 2005 period, the Corporation paid its regular estimated income tax installments.
The net proceeds of investments in the trading portfolio increased by $98.9 million
during the 2005 period. This fluctuation during 2005 is due to the sale of the corporate
bonds portfolio, which was considered as a trading portfolio. In addition, in 2004, the
amount of net acquisitions of investments in the trading portfolio decreased by $12.3
million.
The amount of interest paid increased by $1.8 million in 2005 and $712 thousand in
2004. This increase is principally attributed to the interest paid related to the 6.3%
senior unsecured notes issued and sold by TSI in September 2004.
The contingency reserve funds payment from the Federal Employee Health Benefit Plan
decreased by $4.1 million in 2005 and $7.8 million in 2004. The amount collected from the
contingency reserve funds of the FEHBP was $1.1 million, $5.2 million and $13.0 million
during 2005, 2004 and 2003, respectively. This fluctuation is related to the results of
operations of the program during each particular year.
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The Corporation is currently rehabilitating facilities in one of the two buildings
adjacent to the Corporations main offices, on which the Corporation incurred costs of
approximately $1.6 million during the year 2005 (see Item 2. Properties and section
Planned Capital Expenditures for additional details).
In 2005, TSI acquired approximately $1.0 million of telephone equipment and services
for the operation of the Medicare business call center.
During the year 2005, STS has incurred expenses of approximately $1.0 million related
to the acquisition of a new computer system to manage its insurance operations (see
section Planned Capital Expenditures for additional details.
The change in outstanding checks in excess of bank balances decreased by $2.8 million
during the year 2005 and increased by $9.5 during the year 2004. This represents a timing
difference between the issuance of checks and the cash balance in the bank account at one
point in time.
In the 2005 period the proceeds from short-term borrowings exceeded payments of
short-term borrowings by $40 thousand. On the other hand, in the year 2004 the payment of
short-term borrowings exceeded the proceeds of short-term borrowings by $37.0 million.
Short-term borrowings are used to address timing differences between cash receipts and
disbursements.
The repayments of long-term borrowings increased by $2.5 million during the year 2005
and by $1.0 million in the year 2004. The fluctuations in the repayments of long-term
borrowings are due to additional repayments to one of the Corporations credit agreements
amounting to $3.5 in 2005 and $1.0 million in 2004.
Total long-term borrowings proceeds amounted to $60.0 million and $50.0 million during
the years 2005 and 2004. There were no long-term borrowings proceeds during the year
2003. In 2005, the Corporation received proceeds from the 6.6% senior unsecured notes
amounting to $60.0 million. In 2004, the Corporation received proceeds from the 6.3%
senior unsecured notes amounting to $50.0 million. This represents an increase of $10.0
million in the amount of proceeds received from the issuance of long-term borrowings
during the year 2005.
The amount of net proceeds from annuity contracts during the years 2005, 2004 and 2003
amounted to $6.4 million, $6.4 million and $11.2 million, respectively. This fluctuation
noted between the years 2004 and 2003 is primarily due to the Corporations new deferred
annuity product introduced in late 2002.
On September 30, 2004 TSI issued and sold $50.0 million of its 6.3% senior unsecured
notes due September 2019 (the 6.3% notes). The 6.3% notes are unconditionally guaranteed
as to payment of principal, premium, if any, and interest by the Corporation. The notes
were privately placed to various institutional accredited investors. The notes pay
interest semiannually beginning on March 2005, until such principal becomes due and
payable. These notes can be prepaid after five years at par, in total or partially, as
determined by the Corporation. Most of the proceeds obtained from this issuance were used
to repay $37.0 million of short-term borrowings made by TSI. The remaining proceeds were
used for general business purposes.
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On December 21, 2005 TSM issued and sold $60.0 of its 6.6% senior unsecured notes due
December 2020 (the 6.6% notes). The 6.6% notes were privately placed to various
institutional accredited investors. The notes pay interest each month beginning on
January 2006, until such principal becomes due and payable. These notes can be prepaid
after five years at par, in full or in part, as determined by the Corporation. The
proceeds obtained from this issuance were used to pay the initial ceding commission to GA
Life on the effective date of the coinsurance funds withheld reinsurance agreement
(described in Item 1. Business of this Annual Report on Form 10-K in the section
corresponding to the Life and Disability Insurance segment).
Required Principal
Outstanding
Date
Balance
(amounts in thousands)
$
12,000
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Annuity contracts The cash outflows related to these instruments are not included
since these annuities do not have defined maturities, such that the timing of payments and
withdrawals is uncertain. There are currently no annuities in paying status. As of
December 31, 2005, the Corporation has $41.7 million in annuity contracts.
Other long-term liabilities Due to the indeterminate nature of their cash outflows,
certain categories of other long-term liabilities are not included in the following table.
These include miscellaneous long-term liabilities amounting to $22.4 million.
Contractual obligations by year
(Dollar amounts in thousands)
Total
2006
2007
2008
2009
2010
Thereafter
$
267,991
10,900
22,094
10,069
9,982
9,896
205,050
4,717
1,600
1,370
771
415
371
190
23,646
22,433
1,030
183
268,843
198,939
32,398
12,117
8,898
7,558
8,933
$
565,197
233,872
56,892
23,140
19,295
17,825
214,173
(1)
As of December 31, 2005, the Corporations long-term borrowings consist of $50.0 million of
the 6.3% senior unsecured notes payable, $60.0 million of the 6.6% senior unsecured notes
payable and $40.6 million of loans payable to a commercial bank. Total contractual
obligations for long-term borrowings include the current maturities of long term debt. For
the $50.0 million 6.3% senior unsecured notes; scheduled interest payments (amounting to $43.3
million) were included in the total contractual obligations for long-term borrowings until the
maturity date of the notes in 2019. For the $60.0 million 6.6% senior unsecured notes,
scheduled interest payments (amounting to $59.4 million) were included in the total
contractual obligations for long-term borrowings until the maturity date of the notes in 2020.
According to the terms of the senior notes, prepayments can be made five years after
issuance; however no prepayment is considered in this schedule. The interest payments related
to the Corporations loans payable were estimated using the interest rate outstanding as of
December 31, 2005 for each of the loans. The actual amount of interest payments of the loans
payable will differ from the amount included in this schedule due to the loans variable
interest rate structure. See the Financing and Financing Capacity section for additional
information regarding the Corporations long-term borrowings.
(2)
Purchase obligations represent payments required by the Corporation under material agreements
to purchase goods or services that are enforceable and legally binding and where all
significant terms are specified, including: quantities to be purchased, price provisions and
the timing of the transaction. Other purchase orders made in the ordinary course of business
are excluded from the table above. Any amounts for which the Corporation is liable under
purchase orders are reflected in the audited consolidated balance sheets as accounts payable
and accrued liabilities. Estimated pension plan contributions amounting to $6.0 million were
included within the total purchase obligations. However, this amount is an estimate which may
be subject to change in view of the fact that
contribution decisions are affected by various factors such as market performance, regulatory
and legal requirements and plan funding policy.
(3)
Claim liabilities represent the amount of claims processed and incomplete of the Corporation
as well as an estimate of the amount of incurred but not reported claims and loss-adjustment
expenses. This amount does not include an estimate of claims to be incurred subsequent to
December 31, 2005. The expected claims payments of
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the health insurance, property and
casualty insurance and group life insurance were estimated using claims payment experience.
The expected claims payments of the long-term disability insurance were estimated using
actuarial estimates of expected pay-outs of those policies on which we are currently making
periodic payments. The expected claims payments are an estimate and may not necessarily
present the actual claims payments to be made by the Corporation. Also, the estimated claims
payments included in the table above do not include $28.7 million of reserves ceded under
reinsurance contracts. As of December 31, 2005, the Corporations ceded reserves are included
within the reinsurance recoverable balance in the audited consolidated financial statements.
Since reinsurance contracts do not relieve the Corporation from its obligations to
policyholders, in the event that any of the reinsurance companies is unable to meet its
obligations under the existing reinsurance agreements, the Corporation would be liable for
such defaulted amounts. The Corporation monitors the solvency of its reinsurance carriers and
does not believe the risk of insolvency is significant.
(1)
Legal Proceedings
Various litigation claims and assessments against the
Corporation have arisen in the course of the Corporations business, including but not
limited to, its activities as an insurer and employer. Furthermore, the Commissioner of
Insurance of the Commonwealth of Puerto Rico, as well as other Federal and Puerto Rico
government authorities regularly make inquiries and conduct audits concerning the
Corporations compliance with applicable insurance and other laws and regulations.
Based on the information currently known by the Corporations management, in its
opinion, the outcomes of such pending investigations and legal proceedings are not
likely to have a material adverse effect on the Corporations financial position,
results of operations and cash flows. However, given the inherent unpredictability of
these matters, it is possible that an adverse outcome in certain matters could, from
time to time, have an adverse effect on the Corporations operating results and/or cash
flows (see Item 3. Legal Proceedings of this Annual Report on Form 10-K).
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(2)
Guarantee Association
To operate in Puerto Rico, insurance companies, such
as TSMs insurance subsidiaries, are required to participate in guarantee associations,
which are organized to pay policyholders contractual benefits on behalf of insurers
declared to be insolvent. These associations levy assessments, up to prescribed limits,
on a proportional basis, to all member insurers in the line of business in which the
insolvent insurer was engaged. During the years 2005, 2004 and 2003, the Corporation paid
assessments in connection with insurance companies declared insolvent in the amount of
$965 thousand, $1.1 million and $500 thousand, respectively. It is the opinion of
management that any possible future guarantee association assessments will not have a
material effect on the Corporations operating results and/or cash flows.
Pursuant to the Puerto Rico Insurance Code, the property and casualty insurance segment
is a member of Sindicato de Aseguradores para la Suscripción Conjunta de Seguros de
Responsabilidad Profesional Médico-Hospitalaria (SIMED) and of the Sindicato de
Aseguradores de Responsabilidad Profesional para Médicos. Both syndicates were
organized for the purpose of underwriting medical-hospital professional liability
insurance. As a member, the segment shares risks with other member companies and,
accordingly, is contingently liable in the event the previously mentioned syndicates
cannot meet their obligations. During 2005, 2004 and 2003, no assessment or payment
was made for this contingency.
In addition, pursuant to Article 12 of Rule LXIX of the Insurance Code, the property
and casualty insurance segment is a member of the Compulsory Vehicle Liability
Insurance Joint Underwriting Association (the Association). The Association was
organized in 1997 to underwrite insurance coverage of motor vehicle property damage
liability risks effective January 1, 1998. As a participant, the segment shares the
risk proportionally with other members based on a formula established by the Insurance
Code. During the three-year period ended December 31, 2005, the Association
distributed good experience refunds. The segment received refunds amounting to $918,
$840, and $638 in 2005, 2004, and 2003, respectively.
(Dollar amounts in thousands)
TSI
STS
SVTS
Consolidated
$
74,654
47,416
17,624
139,694
101,184
37,186
4,854
143,224
3,140
11,505
14,645
$
178,978
96,107
22,478
297,563
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(Dollar amounts in thousands)
Completion Factor
1
Claims Trend Factor
2
(Decrease) Increase
(Decrease) Increase
In completion factor
In unpaid claim liabilities
In claims trend factor
In unpaid claim liabilities
$
7,147
(0.6
)%
$
5,797
4,754
(0.4
)%
3,864
2,371
(0.2
)%
1,932
(2,361
)
0.2
%
(1,932
)
(4,711
)
0.4
%
(3,864
)
(7,050
)
0.6
%
(5,797
)
1
Assumes (decrease) increase in the completion factors for the most recent twelve months.
2
Assumes (decrease) increase in the claims trend factors for the most recent twelve months.
(Dollar amounts in thousands)
2004
2003
2002
$
1,054,575
1,026,000
1,032,200
1,070,145
1,030,010
1,018,700
$
(15,570
)
(4,010
)
13,500
-1.5
%
-0.4
%
1.3
%
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Through the management of its cash flows and the investment portfolio.
The Corporation has the ability to increase premium rates throughout the year in the
monthly renewal process, when renegotiating the premiums for the following contract year
of each group as they become due. The Corporation considers the actual claims trend of
each group when determining the premium rates for the following contract year.
The Corporation has available short-term borrowing facilities that from time to time
address differences between cash receipts and disbursements. For additional information
on the Corporations credit facilities, see section Financing and Financing Capacity of
this Item.
are reported) quickly.
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The market risk information is limited by the assumptions and parameters established in
creating the related sensitivity analysis, including the impact of prepayment rates on
mortgages;
The model assumes that the composition of assets and liabilities remains unchanged
throughout the year.
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(1)
Interest Rate Risk
The Corporation has evaluated the net impact to the fair
value of its fixed income investments using a combination of both statistical and
fundamental methodologies. From these shocked values a resultant market price
appreciation/depreciation can be determined after portfolio cash flows are modeled and
evaluated over instantaneous 100, 200 and 300 bp rate shifts. Techniques used in the
evaluation of cash flows include Monte Carlo simulation through a series of probability
distributions over 200 interest rate paths. Necessary prepayment speeds are compiled
using Salomon Brothers Yield Book, which sources numerous factors in deriving speeds,
including but not limited to: historical speeds, economic indicators, street consensus
speeds, etc. Securities evaluated under the aforementioned scenarios include, as it
relates to the Corporation, mortgage pass-through certificates and collateralized mortgage
obligations of U.S. agencies, and private label structures, provided that cash flows
information is available. The following table sets forth the result of this analysis for
the years ended December 31, 2005 and 2004.
(Dollar amounts in thousands)
Expected
Amount of
%
Change in Interest Rates
Fair Value
Decrease
Change
$
560,146
$
532,372
(27,774
)
(4.96
)%
$
512,003
(48,143
)
(8.59
)%
$
492,776
(67,370
)
(12.03
)%
$
482,019
$
465,335
(16,684
)
(3.46
)%
$
446,588
(35,431
)
(7.35
)%
$
428,419
(53,600
)
(11.12
)%
The Corporation believes that an interest rate shift in a 12-month period of 100 bp
represents a moderately adverse outcome, while a 200 bp shift is significantly adverse
and a 300 bp shift is unlikely given historical precedents. Although the Corporation
classifies 96% of its fixed income securities as available-for-sale, the Corporations
cash flows and the intermediate duration of its investment portfolio should allow it to
hold securities until their maturity, thereby avoiding the recognition of losses,
should interest rates rise significantly.
(2)
Equity Price Risk
The Corporations equity securities in the
available-for-sale portfolio are comprised primarily of stock of several Puerto Rico
financial institutions and mutual funds. Assuming an immediate decrease of 10% in the
market value of these securities as of December 31, 2005 and 2004, the hypothetical loss
in the fair value of these investments is estimated to be approximately $5.2 million and
$5.9 million, respectively.
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Financial Statements
Description
Report of Independent Registered Public Accounting Firm
Consolidated Balance Sheets as of December 31, 2005 and 2004
Consolidated Statements of Earnings for the years ended
December 31, 2005, 2004 and 2003
Consolidated Statements of Stockholders Equity and
Comprehensive Income for the years ended December 31, 2005,
2004 and 2003
Consolidated Statements of Cash Flows for the years ended
December 31, 2005, 2004 and 2003
Notes to Consolidated Financial Statements December 31,
2005, 2004 and 2003
Financial Statements
Schedules
Description
Schedule II Condensed Financial Information of the Registrant
Schedule III Supplementary Insurance Information
Schedule IV Reinsurance
Schedule V Valuation and Qualifying Accounts
Exhibits
Description
Articles of Incorporation of Triple-S Management Corporation as
amended (English Translation) (incorporated herein by reference
to Exhibit 3(i) to TSMs Quarterly Report on Form 10-Q for the
Quarter Ended June 30, 2002 (File No. 0-49762)).
By-Laws of Triple-S Management Corporation as amended (English
Translation) (incorporated herein by reference to Exhibit 3(ii)
to TSMs Quarterly Report on Form 10-Q for the Quarter Ended June
30, 2002 (File No. 0-49762)).
Puerto Rico Health Insurance Contract for the Metro-North Region
(incorporated herein by reference to Exhibit 10.1 to TSMs
Quarterly Report on Form 10-Q for the Quarter Ended June 30, 2003
(File No. 0-49762)).
Extension to the Puerto Rico Health Insurance Contract for the
Metro-North Region (incorporate herein by reference to Exhibit
10.1 to TSMs Quarterly Report on Form 10-Q for the Quarter Ended
September 30, 2005 (File No. 0-49762)).
Puerto Rico Health Insurance Contract for the North Region
(incorporated herein by reference to Exhibit 10.2 to TSMs
Quarterly Report on Form 10-Q for the Quarter Ended June 30, 2003
(File No. 0-49762)).
Extension to the Puerto Rico Health Insurance Contract for the
North Region (incorporate herein by reference to Exhibit 10.2 to
TSMs Quarterly Report on Form 10-Q for the Quarter Ended
September 30, 2005 (File No. 0-49762)).
Puerto Rico Health Insurance Contract for the South-West Region
(incorporated herein by reference to Exhibit 10.3 to TSMs
Quarterly Report on Form 10-Q for the Quarter Ended June 30, 2003
(File No. 0-49762)).
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Extension to the Puerto Rico Health Insurance Contract for the
South-West Region (incorporate herein by reference to Exhibit
10.3 to TSMs Quarterly Report on Form 10-Q for the Quarter Ended
September 30, 2005 (File No. 0-49762)).
Employment Contract with Mr. Ramón Ruiz Comas, CPA (incorporated
herein by reference to Exhibit 10.4 to TSMs Quarterly Report on
Form 10-Q for the Quarter Ended June 30, 2002 (File No.
0-49762)).
Employment Contract with Ms. Socorro Rivas, CPA (incorporated
herein by reference to Exhibit 10.5 to TSMs Quarterly Report on
Form 10-Q for the Quarter Ended June 30, 2002 (File No.
0-49762)).
Employment Contract with Dr. Alejandro Franco (incorporated
herein by reference to Exhibit 10.9 to TSMs General Form of
Registration of Securities on Form 10 (File No. 0-49762)).
Federal Employees Health Benefits Contract (incorporated herein
by reference to Exhibit 10.5 to TSMs General Form of
Registration of Securities on Form 10 (File No. 0-49762)).
Credit Agreement with FirstBank Puerto Rico in the amount of
$41,000,000 (incorporated herein by reference to Exhibit 10.6 to
TSMs General Form of Registration of Securities on Form 10 (File
No. 0-49762)).
Credit Agreement with FirstBank Puerto Rico in the amount of
$20,000,000 (incorporated herein by reference to Exhibit 10.7 to
TSMs General Form of Registration of Securities on Form 10 (File
No. 0-49762)).
Non-Contributory Retirement Program (incorporated herein by
reference to Exhibit 10.8 to TSMs General Form of Registration
of Securities on Form 10 (File No. 0-49762)).
License and other Agreements with Blue Shield (incorporated
herein by reference to Exhibit 10.10 to TSMs General Form of
Registration of Securities on Form 10 (File No. 0-49762)).
Employment Contract with Dr. Francisco Joglar-Pesquera
(incorporated herein by reference to Exhibit 10.2 to TSMs
Quarterly Report on Form 10-Q for the Quarter Ended June 30, 2005
(File No. 0-49762)).
Stock Purchase Agreement by and between Triple-S Management
Corporation and Great American Financial Resources, Inc. dated
December 15, 2005 (incorporated herein by reference to Exhibit
10.1 to TSMs Current Report on Form 8-K filed on December 21,
2005 (File No. 0-49762)).
Reinsurance Agreement between Great American Life Assurance
Company of Puerto Rico and Seguros de Vida Triple-S, Inc. dated
December 15, 2005.
6.30% Senior Unsecured Notes Due September 2019 Note Purchase
Agreement, dated September 30, 2004, between Triple-S Management
Corporation, Triple-S, Inc. and various institutional accredited
investors.
6.60% Senior Unsecured Notes Due December 2020 Note Purchase
Agreement, dated December 15, 2005, between Triple-S Management
Corporation and various institutional accredited investors.
Statement re computation of per share earnings; an exhibit
describing the computation of the earnings per share for the
years ended December 31, 2005, 2004 and 2003 has been omitted as
the detail necessary to determine the computation of earnings per
share can be clearly determined from the notes to the
consolidated financial statements.
Statement re computation of ratios; an exhibit describing the
computation of the loss ratio, expense ratio and combined ratio
for the years ended December 31, 2005, 2004 and 2003 has been
omitted as the detail necessary to determine the computation of
earnings per share can be clearly determined from the material
contained in Part II of this Annual Report on Form 10-K.
Triple-S Management Corporation Annual Report to Shareholders for
the year ended December 31, 2005.
Code of Ethics
Certification of the President and Chief Executive Officer
required by Rule 13a-14(a)/15d-14(a).
Certification of the Vice President of Finance and Chief
Financial Officer required by Rule 13a-14(a)/15d-14(a).
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Certification of the President and Chief Executive Officer
required pursuant to 18 U.S. Section 1350.
Certification of the Vice President of Finance and Chief
Financial Officer required pursuant to 18 U.S. Section 1350.
List of Subsidiaries of the Corporation (incorporated herein by
reference to Exhibit 21 to TSMs General Form of Registration of
Securities on Form 10 (File No. 0-49762)).
Registrant
/s/ Ramón M. Ruiz-Comas
Date:
March 30, 2006
Ramón M. Ruiz-Comas
President and Chief Executive Officer
/s/ Juan J. Román
Date:
March 30, 2006
Juan J. Román
Vice President of Finance and
Chief Financial Officer
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/s/ Wilmer Rodríguez-Silva, MD
Date:
March 30, 2006
Wilmer Rodríguez-Silva, MD
Director and Chairman of the Board
/s/ Mario S. Belaval
Date:
March 30, 2006
Mr. Mario S. Belaval
Director and Vice-Chairman of the Board
/s/ Jesús R. Sánchez-Colón, MD
Date:
March 30, 2006
Jesús R. Sánchez-Colón, MD
Director and Secretary of the Board
/s/ Miguel Nazario-Franco
Date:
March 30, 2006
Miguel Nazario-Franco
Director and Assistant Secretary of the Board
/s/ Vicente J. León-Irizarry, CPA
Date:
March 30, 2006
Vicente J. León-Irizarry, CPA
Director and Treasurer of the Board
/s/ Adamina Soto-Mártinez, CPA
Date:
March 30, 2006
Adamina Soto-Mártinez, CPA
Director and Assistant Treasurer of the Board
/s/ Valeriano Alicea-Cruz, MD
Date:
March 30, 2006
Valeriano Alicea-Cruz, MD
Director
/s/ José Árturo Álvarez-Gallardo
Date:
March 30, 2006
Mr. José Árturo Álvarez-Gallardo
Director
/s/ Arturo R. Córdova-López, MD
Date:
March 30, 2006
Arturo R. Córdova-López, MD
Director
/s/ Carmen Ana Culpeper-Ramírez
Date:
March 30, 2006
Ms. Carmen Ana Culpeper-Ramírez
Director
/s/ Porfirio E. Díaz-Torres, MD
Date:
March 30, 2006
Porfirio E. Díaz-Torres, MD
Director
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/s/ Manuel Figueroa-Collazo, PE
Date:
March 30, 2006
Manuel Figueroa-Collazo, PE, Ph.D.
Director
/s/ José Hawayek-Alemañy, MD
Date:
March 30, 2006
José Hawayek-Alemañy, MD
Director
/s/ Fernando L. Longo, MD
Date:
March 30, 2006
Fernando L. Longo, MD
Director
/s/ Wilfredo López-Hernández, MD
Date:
March 30, 2006
Wilfredo López-Hernández, MD
Director
/s/ Juan E. Rodríguez-Díaz, Esq.
Date:
March 30, 2006
Juan E. Rodríguez-Díaz, Esq.
Director
/s/ Manuel Suárez-Méndez, P.E.
Date:
March 30, 2006
Manuel Suárez-Méndez, P.E.
Director
/s/ Fernando J. Ysern Borrás, MD
Date:
March 30, 2006
Fernando J. Ysern Borrás, MD
Director
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Page
1
2
3
4
5
7
7
8
19
26
35
35
36
36
37
39
40
41
43
44
45
46
48
51
55
57
57
60
61
61
61
64
66
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Triple-S Management Corporation:
San Juan, Puerto Rico
Society of Certified Public Accountants
was affixed to the record copy of this report.
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2005
2004
$
72,423
78,215
86,596
515,174
444,637
51,810
59,186
21,129
14,280
48,978
35,115
715,306
712,237
244,038
113,323
81,568
18,712
34,709
32,364
2,151
59,690
43,021
$
1,137,462
919,657
$
139,694
137,282
143,224
127,324
14,645
14,719
297,563
279,325
118,635
95,703
84,583
41,738
34,071
4,356
9,791
106,468
100,388
1,740
1,700
150,590
95,730
1,827
1,969
11,966
8,840
828,759
618,224
356
356
150,408
150,408
162,964
134,531
(5,025
)
16,138
308,703
301,433
$
1,137,462
919,657
Table of Contents
2005
2004
2003
$
1,380,204
1,298,959
1,264,395
210,905
179,166
160,127
(196,460
)
(169,924
)
(151,806
)
1,394,649
1,308,201
1,272,716
29,029
26,499
24,679
7,161
10,968
8,365
(4,709
)
3,042
14,893
3,732
3,360
4,703
1,429,862
1,352,070
1,325,356
1,208,367
1,115,793
1,065,350
181,703
171,879
165,149
7,595
4,581
3,231
1,397,665
1,292,253
1,233,730
32,197
59,817
91,626
3,924
14,285
70,793
(160
)
(271
)
(5,396
)
3,764
14,014
65,397
$
28,433
45,803
26,229
$
3,193
5,135
2,857
Table of Contents
and Comprehensive Income
Accumulated
Additional
other
Total
Common
paid-in
Retained
comprehensive
stockholders
stock
capital
earnings
income (loss)
equity
$
373
150,406
62,499
18,386
231,664
(12
)
1
(11
)
26,229
26,229
(6,022
)
(6,022
)
2,292
2,292
103
103
22,602
361
150,407
88,728
14,759
254,255
(5
)
1
(4
)
45,803
45,803
1,101
1,101
(3
)
(3
)
281
281
47,182
356
150,408
134,531
16,138
301,433
28,433
28,433
(18,832
)
(18,832
)
(2,788
)
(2,788
)
457
457
7,270
$
356
150,408
162,964
(5,025
)
308,703
Table of Contents
2005
2004
2003
$
1,388,623
1,302,383
1,267,127
(257,822
)
(182,333
)
(169,160
)
(1,193,548
)
(1,092,817
)
(1,066,527
)
28,826
27,065
25,139
(9,118
)
(44,680
)
(39,287
)
102,667
50,330
77,582
36,156
26,523
28,924
(30,502
)
(54,550
)
(96,237
)
(25,785
)
(38,700
)
(38,956
)
(5,351
)
(3,578
)
(2,866
)
13,886
13,980
11,387
1,059
5,217
13,023
49,091
8,840
10,149
13,099
86,112
129,868
22,822
69,258
196,961
3,488
8,436
16,778
1,816
1,322
1,010
(118,758
)
(194,016
)
(416,759
)
(6,876
)
(2,435
)
(14,824
)
(8,495
)
(10,154
)
(537
)
(7,574
)
(3,494
)
(3,205
)
15
63
(100,478
)
(44,956
)
(90,645
)
5
(Continued)
Table of Contents
2005
2004
2003
$
3,914
6,730
(2,739
)
(174,035
)
(57,355
)
174,075
20,355
38,700
(5,140
)
(2,645
)
(1,640
)
60,000
50,000
(4
)
(11
)
11,510
11,002
13,471
(5,074
)
(4,595
)
(2,318
)
65,250
23,488
45,463
13,863
(12,628
)
(35,033
)
35,115
47,743
82,776
$
48,978
35,115
47,743
Table of Contents
(1)
Organization
(a)
Nature of Business
Triple-S Management Corporation (the Company or TSM) was incorporated under the laws of
the Commonwealth of Puerto Rico on January 17, 1997 to engage, among other things, as the
holding company of entities primarily involved in the insurance industry.
The Company has the following wholly owned subsidiaries that are subject to the
regulations of the Commissioner of Insurance of the Commonwealth of Puerto Rico (the
Commissioner of Insurance): (1) Triple-S, Inc. (TSI) which provides hospitalization and
health benefits to subscribers through contracts with hospitals, physicians, dentists,
laboratories, and other organizations located mainly in Puerto Rico; (2) Seguros de Vida
Triple-S, Inc. (SVTS), which is engaged in the underwriting of life and disability
insurance policies and the administration of annuity contracts; and (3) Seguros Triple-S,
Inc. (STS), which is engaged in the underwriting of property and casualty insurance
policies. The Company and TSI are members of the Blue Cross and Blue Shield Association
(BCBSA).
The Company also has two other wholly owned subsidiaries, Interactive Systems, Inc. (ISI)
and Triple-C, Inc. (TC). ISI is mainly engaged in providing data processing services to
the Company and its subsidiaries. TC is mainly engaged as a third-party administrator for
TSI in the administration of the Commonwealth of Puerto Rico Health Care Reforms
business (the Reform). Also, TC provides health care advisory services to TSI and other
health insurance-related services to the health insurance industry.
A substantial majority of the Companys business activity is with insureds located
throughout Puerto Rico, and as such, the Company is subject to the risks associated with
the Puerto Rico economy.
(b)
Reorganization of the Business
On December 6, 1996, the Commissioner of Insurance issued an order to annul the sale of
1,582 shares of common stock that TSI repurchased from the estate of deceased
stockholders. TSI contested such order through administrative and judicial review
processes. Consequently, the sale of 1,582 shares was cancelled and the amounts paid
returned to each former stockholder. During the year 2000, the Commissioner of Insurance
issued a pronouncement providing further clarification of the content and effect of the
order. This order also required that all corporate decisions undertaken by TSI through
the vote of its stockholders of record, be ratified in a stockholders meeting or in a
subsequent referendum. In November 2000, TSM, as the sole stockholder of TSI, ratified
all such decisions. Furthermore, on November 19, 2000, TSM held a special stockholders
meeting, where a ratification of these decisions was undertaken except for the
resolutions related to the approval of the reorganization of TSI and its subsidiaries.
This resolution did not reach the two-thirds majority required by the order because the
number of shares that were present and represented at the meeting was below such amount
(total shares present and represented in the stockholders meeting was 64%). As
stipulated in the order, TSM began the process to conduct a referendum among its
stockholders in order to ratify such resolution. The process was later suspended because
upon further review of the
7
(Continued)
Table of Contents
scope of the order, the Commissioner of Insurance issued an opinion in a letter dated
January 8, 2002, which indicated that the ratification of the corporate reorganization
was not required.
In another letter to TSI dated March 14, 2002, the Commissioner of Insurance stated that
the ratification of the corporate reorganization was not required and that TSI had
complied with the Commissioner of Insurances order of December 6, 1996 related to the
corporate reorganization. Thereafter, two of TSMs stockholders filed a petition for
review of the Commissioner of Insurances determination before the Puerto Rico Circuit
Court of Appeals. Such petition was opposed by TSI and by the Commissioner of Insurance.
Pursuant to that review, on September 24, 2002, the Puerto Rico Circuit Court of Appeals
issued an order requiring the Commissioner of Insurance to order that a meeting of
shareholders be held to ratify TSIs corporate reorganization and the change of name of
TSI from Seguros de Servicios de Salud de Puerto Rico, Inc. to Triple-S, Inc. The Puerto
Rico Circuit Court of Appeals based its decision on administrative and procedural issues
directed at the Commissioner of Insurance. The Commissioner of Insurance filed a motion
of reconsideration with the Puerto Rico Circuit Court of Appeals on October 11, 2002. TSM
and TSI also filed a motion of reconsideration.
On October 25, 2002, the Puerto Rico Circuit Court of Appeals dismissed the Commissioner
of Insurances Motion for Reconsideration.
On May 18, 2003, the Puerto Rico Circuit Court of Appeals granted TSIs and TSMs Motion
of Reconsideration. The Puerto Rico Circuit Court of Appeals held that the Commissioner
of Insurance had the authority to waive the celebration of a referendum to ratify TSIs
reorganization and that therefore the reorganization of TSI, inasmuch as the 1,582 shares
annulled were not decisive, was approved by the stockholders.
On June 26, 2003, the two shareholders presented a Writ of Certiorari before the Supreme
Court of Puerto Rico. TSI and TSM filed a motion opposing the
issuance of the writ. The Supreme Court of Puerto Rico issued the writ on August 22, 2003, when it ordered that the
Puerto Rico Circuit Court of Appeals transmit the record of the case. On December 1,
2003, the two shareholders filed a motion submitting their case on the basis of their
original petition. TSI filed its brief on December 30, 2003, while the Commissioner of
Insurance, in turn, filed a separate brief on December 31, 2003. On June 24, 2004, the
Supreme Court of Puerto Rico ordered the plaintiffs to file a brief in support of their
allegations. The outcome of the case is pending before the Supreme Court of Puerto Rico.
It is the opinion of the management and its legal counsels that the corporate
reorganization as approved is in full force and effect.
(2)
Significant Accounting Policies
The following are the significant accounting policies followed by the Company and its subsidiaries:
(a)
Basis of Presentation
The accompanying consolidated financial statements have been prepared in conformity with
U.S. generally accepted accounting principles (GAAP). These principles are established
primarily by the
8
(Continued)
Table of Contents
Financial Accounting Standards Board (FASB) and the American Institute of Certified
Public Accountants.
The consolidated financial statements include the financial statements of the Company and
its subsidiaries. All significant intercompany balances and transactions have been
eliminated in consolidation.
(b)
Cash Equivalents
Cash equivalents of $28,030 and $3,617 at December 31, 2005 and 2004, respectively,
consist principally of certificates of deposit and obligations of the Commonwealth of
Puerto Rico and the U.S. Treasury with an initial term of less than three months. For
purposes of the consolidated statements of cash flows, the Company considers all highly
liquid debt instruments with original maturities of three months or less to be cash
equivalents.
(c)
Investments
Investment in securities at December 31, 2005 and 2004 consists mainly of U.S. Treasury
securities and obligations of U.S. government instrumentalities, obligations of the
Commonwealth of Puerto Rico and its instrumentalities, obligations of state and political
subdivisions, mortgage-backed securities, collateralized mortgage obligations, corporate
debt, and equity securities. The Company classifies its debt and equity securities in one
of three categories: trading, available for sale, or held to maturity. Trading securities
are bought and held principally for the purpose of selling them in the near term.
Securities classified as held to maturity are those securities in which the Company has
the ability and intent to hold the security until maturity. All other securities not
included in trading or held to maturity are classified as available for sale.
Trading and available-for-sale securities are recorded at fair value. Held-to-maturity
debt securities are recorded at amortized cost, adjusted for the amortization or
accretion of premiums and discounts. Unrealized holding gains and losses on trading
securities are included in operations. Unrealized holding gains and losses, net of the
related tax effect, on available-for-sale securities are excluded from operations and are
reported as a separate component of other comprehensive income until realized. Transfers
of securities between categories are recorded at fair value at the date of transfer.
Unrealized holding gains and losses are recognized in operations for transfers into
trading securities. Unrealized holding gains or losses associated with transfers of
securities from held to maturity to available for sale are recorded as a separate
component of other comprehensive income. The unrealized holding gains or losses included
in the separate component of other comprehensive income for securities transferred from
available for sale to held to maturity, are maintained and amortized into operations over
the remaining life of the security as an adjustment to yield in a manner consistent with
the amortization or accretion of premium or discount on the associated security.
A decline in the fair value of any available-for-sale or held-to-maturity security below
cost, that is deemed to be other than temporary, results in a reduction in carrying
amount to fair value. The impairment is charged to earnings and a new cost basis for the
security is established. To determine whether an impairment is other than temporary, the
Company considers whether it has the ability and
9
(Continued)
Table of Contents
intent to hold the investment until a market price recovery and considers whether
evidence indicating the cost of the investment is recoverable outweighs evidence to the
contrary. Evidence considered in this assessment includes the reasons for the impairment,
the severity and duration of the impairment, market conditions, changes in value
subsequent to period-end and forecasted performance of the investee.
Premiums and discounts are amortized or accreted over the life of the related
held-to-maturity or available-for-sale security as an adjustment to yield using the
effective interest method. Dividend and interest income are recognized when earned.
Realized gains and losses from the sale of available-for-sale securities are included in
operations and are determined on a specific-identification basis.
(d)
Revenue Recognition
Subscriber premiums on health and life insurance policies are billed in advance of their
respective coverage period and the related revenue is recorded as earned during the
coverage period. The premiums of TSI and SVTS are billed in the month prior to the
effective date of the policy with a grace period of one month. If the insured fails to
pay, the policy can be canceled at the end of the grace period at the option of the
companies. Health and life insurance premiums are reported as earned when due.
Certain groups have health insurance contracts that provide for the group to be at risk
for all or a portion of their claims experience. For these groups, the Company is not at
risk and only handles the administration of the insurance coverage for an administrative
fee. The Company pays claims under self-funded arrangements from its own bank accounts,
and subsequently receives reimbursement from the self-funded groups. Revenue recorded
under the self-funded arrangements are recognized based on the incurred claims for the
period plus administrative and other fees and are labeled as amounts attributable to
self-funded arrangements in the accompanying consolidated statements of earnings. In
addition, some of these self-funded groups purchase aggregate and/or specific stop-loss
coverage. In exchange for a premium, the groups aggregate liability or the groups
liability on any one episode of care is capped for the year. Premiums for the stop-loss
coverage are actuarially determined based on experience and other factors and are
recorded as earned over the period of the contract in proportion to the coverage
provided. This fully-insured portion of premiums is included within the premiums earned,
net in the accompanying consolidated statements of earnings. In addition, accounts for
certain self-insured groups are charged or credited with interest expense or income as
provided by the groups contracts.
10
(Continued)
Table of Contents
The detail by funding option of the amount of revenue attributable to self-funded
arrangements for the years ended December 31, 2005, 2004, and 2003 is as follows:
2005
2004
2003
$
195,390
165,921
147,972
15,515
13,245
12,155
$
210,905
179,166
160,127
$
1,117
1,436
1,234
775
1,100
927
$
1,892
2,536
2,161
Premiums on property and casualty contracts are recognized as earned on a pro rata basis
over the policy term. The portion of premiums related to the period prior to the end of
coverage is recorded in the consolidated balance sheets as unearned premiums and is
transferred to premium revenue as earned.
(e)
Allowance for Doubtful Receivables
The allowance for doubtful receivables is based on managements evaluation of the aging
of accounts and such other factors, which deserve current recognition. Actual results
could differ from these estimates. Receivables are charged against their respective
allowance accounts when deemed to be uncollectible.
(f)
Deferred Policy Acquisition Costs
Certain costs for acquiring property and casualty, and life and disability insurance
business are deferred by the Company. In the property and casualty business these costs
mainly relate to commissions incurred during the production of business and are deferred
and amortized ratably over the terms of the policies. In the life and disability
insurance business the deferred acquisition costs mainly relate to the production of
life, annuity, accident and health, and credit business. The amortization of the deferred
acquisition costs of the life and disability insurance business is provided considering
interest, over the anticipated premium paying period of the related policies in
proportion to the ratio of annual premium revenue to expected total premium revenue to be
received over the life of the policies. The expected premium revenue of the life and
disability insurance subsidiary is estimated by using the same mortality and withdrawal
assumptions used in computing liabilities for future policy benefits. Cost deferred by
the life and disability insurance segment related to interest sensitive products are
amortized as a level percentage of the present value of anticipated gross profits from
investment yields, mortality, and surrender charges.
11
(Continued)
Table of Contents
The method used in calculating deferred policy acquisition costs limits the amount of
such deferred costs to actual costs or their estimated realizable value, whichever is
lower. In determining estimated realizable value, the method considers the premiums to be
earned, related investment income, losses and loss-adjustment expenses, and certain other
costs expected to be incurred as the premiums are earned.
Amortization of deferred policy acquisition costs in 2005, 2004, and 2003 was $23,401,
$22,454, and $19,580, respectively.
Acquisition costs related to health insurance policies are expensed as incurred.
(g)
Property and Equipment
Property and equipment are stated at cost. Maintenance and repairs are expensed as
incurred. Depreciation is calculated on the straight-line method over the estimated
useful lives of the assets. Costs of computer equipment, programs, systems,
installations, and enhancements are capitalized and amortized straight-line over their
estimated useful lives. The following is a summary of the estimated useful lives of the
Companys property and equipment:
Estimated
Asset category
useful life
20 to 50 years
Building improvements
3 to 5 years
Leasehold improvements
Shorter of estimated useful
life or lease term
Office furniture
5 years
Equipment
3 years
(h)
Claim Liabilities
Claims processed and incomplete and unreported losses for health insurance policies
represent the estimated amounts to be paid to providers based on experience and
accumulated statistical data. Loss-adjustment expenses related to such claims are accrued
currently based on estimated future expenses necessary to process such claims.
TSI contracts with various independent practice associations (IPAs) for certain medical
care services provided to managed care policies subscribers. The IPAs are compensated on
a capitation basis. TSI retains a portion of the capitation payments to provide for
incurred but not reported losses. At December 31, 2005 and 2004, total withholdings and
capitation payable amounted to $27,327 and $27,924, respectively, which are recorded as
part of the liability for claims processed and incomplete in the accompanying
consolidated balance sheets.
The liability for losses and loss-adjustment expenses for STS represents individual case
estimates for reported claims and estimates for unreported losses, net of any salvage and
subrogation based on past
12
(Continued)
Table of Contents
experience modified for current trends and estimates of expenses for investigating and
settling claims.
The liability for policy and contract claims of SVTS is based on the amount of benefits
contractually determined for reported claims, and on estimates, based on past experience
modified for current trends, for unreported claims.
The above liabilities are necessarily based on estimates and, while management believes
that the amounts are adequate, the ultimate liability may be in excess of or less than
the amounts provided. The methods for making such estimates and for establishing the
resulting liability are continually reviewed, and any adjustments are reflected in the
consolidated statements of earnings in the period determined.
(i)
Annuity Contracts
Amounts received for annuity contracts are considered deposits and recorded as a
liability. Interest accrued on such annuities, which amounted to $1,230, $1,004, and $721
during the years ended December 31, 2005, 2004, and 2003, respectively, is recorded as
interest expense in the accompanying consolidated statements of earnings.
(j)
Reinsurance
(i)
Reinsurance Ceded
In the normal course of business, the insurance-related subsidiaries seek to limit
their exposure that may arise from catastrophes or other events that cause
unfavorable underwriting results by reinsuring certain levels of risk in various
areas of exposure with other insurance enterprises or reinsurers.
Reinsurance premiums, commissions, and expense reimbursements, related to reinsured
business are accounted for on bases consistent with those used in accounting for
the original policies issued and the terms of the reinsurance contracts.
Accordingly, reinsurance premiums are reported as prepaid reinsurance premiums and
amortized over the remaining contract period in proportion to the amount of
insurance protection provided.
Premiums ceded and recoveries of losses and loss-adjustment expenses have been
reported as a reduction of premiums earned and losses and loss-adjustment expenses
incurred, respectively. Commission and expense allowances received by STS in
connection with reinsurance ceded have been accounted for as a reduction of the
related policy acquisition costs and are deferred and amortized accordingly.
Amounts recoverable from reinsurers are estimated in a manner consistent with the
claim liability associated with the reinsured policy.
(ii)
Reinsurance Assumed
SVTS in an effort to participate in the individual life insurance business,
reinsures premiums of this line of business on a coinsurance funds withheld basis.
13
(Continued)
Table of Contents
In this arrangement, SVTS shares proportionally in all of the risks inherent in the
underlying policies, including mortality, persistency, and fluctuations in the
investment results. In this agreement SVTS agrees to indemnify the primary insurer
for a portion of the risks associated with the underlying insurance policies in
exchange for a proportionate share of the premiums. Under coinsurance funds
withheld arrangements the primary insurer retains the ownership of the assets
supporting the reserves of the reinsured business, however, SVTS participates in
the investment income and risks associated with the assets.
Reinsurance premiums, claims incurred and commissions and other expenses related to
reinsured business are accounted for on bases consistent with those used in
accounting for the original policies issued and the terms of the reinsurance
contracts.
Assumed premiums and SVTSs share of losses have been reported as premiums earned
and losses incurred, respectively. Commissions and other deferrable expenses paid
by SVTS in connection with reinsurance assumed have been accounted for as policy
acquisition costs and are deferred and amortized accordingly.
(k)
Derivative Instruments and Hedging Activities
The Company accounts for derivative instruments, including certain derivative instruments
embedded in other contracts, and hedging activities in accordance with the provisions of
Statement of Financial Accounting Standards (SFAS) No. 133,
Accounting for Derivative
Instruments and Certain Hedging Activities
, and SFAS No. 138,
Accounting for Certain
Derivative Instruments and Certain Hedging Activities
, an Amendment to SFAS No. 133. This
statement, as amended, requires that all derivative instruments, whether or not
designated in hedging relationships, be recorded on the balance sheets at their
respective fair values. Changes in the fair value of derivative instruments are recorded
in earnings, unless specific hedge accounting criteria are met in which case the change
in fair value of the instrument is recorded within other comprehensive income.
On the date the derivative contract designated as a hedging instrument is entered into,
the Company designates the instrument as either a hedge of the fair value of a recognized
asset or liability or of an unrecognized firm commitment (fair-value hedge), a hedge of a
forecasted transaction or the variability of cash flows to be received or paid related to
a recognized asset or liability (cash-flow hedge), a foreign currency fair value or
cash-flow hedge (foreign-currency hedge), or a hedge of a net investment in a foreign
operation. For all hedging relationships the Company formally documents the hedging
relationship and its risk-management objective and strategy for undertaking the hedge,
the hedging instrument, the hedged item, the nature of the risk being hedged, how the
hedging instruments effectiveness in offsetting the hedged risk will be assessed, and a
description of the method of measuring ineffectiveness. This process includes linking all
derivatives that are designated as fair-value, cash-flow, or foreign-currency hedges to
specific assets and liabilities on the balance sheet or to specific firm commitments or
forecasted transactions. The Company also formally assesses, both at the hedges
inception and on an ongoing basis, whether the derivatives that are used in hedging
transactions are highly effective in offsetting changes in fair values or cash flows of
hedged items. Changes in the fair value of a derivative that is highly effective and that
is designated and qualifies as a fair-value hedge, along with the loss or gain on the
hedged asset or
14
(Continued)
Table of Contents
liability or unrecognized firm commitment of the hedged item that is attributable to the
hedged risk, are recorded in earnings. Changes in the fair value of a derivative that is
highly effective and that is designated and qualifies as a cash-flow hedge are recorded
in other comprehensive income to the extent that the derivative is effective as hedge,
until earnings are affected by the variability in cash flows of the designated hedged
item. Changes in the fair value of derivatives that are highly effective as hedges and
that are designated and qualify as foreign-currency hedges are recorded in either
earnings or other comprehensive income, depending on whether the hedge transaction is a
fair-value hedge or a cash-flow hedge. However, if a derivative is used as a hedge of a
net investment in a foreign operation, its changes in fair value, to the extent effective
as a hedge, are recorded in the cumulative translation adjustments account within other
comprehensive income. The ineffective portion of the change in fair value of a derivative
instrument that qualifies as either a fair-value hedge or a cash-flow hedge is reported
in earnings. Changes in the fair value of derivative trading instruments are reported in
current period earnings.
The Company discontinues hedge accounting prospectively when it is determined that the
derivative is no longer effective in offsetting changes in the fair value or cash flows
of the hedged item, the derivative expires or is sold, terminated, or exercised, the
derivative is de-designated as a hedging instrument, because it is unlikely that a
forecasted transaction will occur, a hedged firm commitment no longer meets the
definition of a firm commitment, or management determines that designation of the
derivative as a hedging instrument is no longer appropriate.
In all situations in which hedge accounting is discontinued and the derivative is
retained, the Company continues to carry the derivative at its fair value on the balance
sheet and recognizes any subsequent changes in its fair value in earnings. When hedge
accounting is discontinued because it is determined that the derivative no longer
qualifies as an effective fair-value hedge, the Company no longer adjusts the hedged
asset or liability for changes in fair value. The adjustment of the carrying amount of
the hedged asset or liability is accounted for in the same manner as other components of
the carrying amount of that asset or liability. When hedge accounting is discontinued
because the hedged item no longer meets the definition of a firm commitment, the Company
removes any asset or liability that was recorded pursuant to recognition of the firm
commitment from the balance sheet, and recognizes any gain or loss in earnings. When it
is probable that a forecasted transaction will not occur, the Company discontinues hedge
accounting if not already done and recognizes immediately in earnings gains and losses
that were accumulated in other comprehensive income.
(l)
Income Taxes
Income taxes are accounted for under the asset and liability method. Deferred tax assets
and liabilities are recognized for the future tax consequences attributable to
differences between the financial statement carrying amounts of existing assets and
liabilities and their respective tax bases and operating loss and tax credit
carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates
expected to apply to taxable income in the years in which those temporary differences are
expected to be recovered or settled. The effect on deferred tax assets and liabilities of
a change in tax rates is recognized in the consolidated statements of earnings in the
period that includes the enactment date.
15
(Continued)
Table of Contents
(m)
Insurance-related Assessments
The Company accounts for insurance-related assessments in accordance with the provisions
of Statement of Position (SOP) No. 97-3,
Accounting by Insurance and Other Enterprises
for Insurance-related Assessments
. This SOP prescribes liability recognition when the
following three conditions are met: (1) the assessment has been imposed or the
information available prior to the issuance of the financial statements indicates it is
probable that an assessment will be imposed; (2) the event obligating an entity to pay
(underlying cause of) an imposed or probable assessment has occurred on or before the
date of the financial statements; and (3) the amount of the assessment can be reasonably
estimated. Also, this SOP provides for the recognition of an asset when the paid or
accrued assessment is recoverable through either premium taxes or policy surcharges.
(n)
Impairment of Long-lived Assets
In accordance with SFAS No. 144,
Accounting for the Impairment or Disposal of Long-lived
Assets
, long-lived assets, such as property, plant, and equipment, and purchased
intangible assets subject to amortization, are reviewed for impairment whenever events or
changes in circumstances indicate that the carrying amount of an asset may not be
recoverable. Recoverability of assets to be held and used is measured by a comparison of
the carrying amount of an asset to estimated undiscounted future cash flows expected to
be generated by the asset. If the carrying amount of an asset exceeds its estimated
future cash flows, an impairment charge is recognized by the amount by which the carrying
amount of the asset exceeds the fair value of the asset. Assets to be disposed of would
be separately presented in the balance sheets and reported at the lower of the carrying
amount or fair value less costs to sell, and are no longer depreciated. The assets and
liabilities of a disposal group classified as held for sale would be presented separately
in the appropriate asset and liability sections of the balance sheets.
Goodwill and intangible assets that have indefinite useful lives are tested annually for
impairment, and are tested for impairment more frequently if events and circumstances
indicate that the asset might be impaired. An impairment loss is recognized to the extent
that the carrying amount exceeds the assets fair value. For goodwill, the impairment
determination is made at the reporting unit level and consists of two steps. First, the
Company determines the fair value of a reporting unit and compares it to its carrying
amount. Second, if the carrying amount of a reporting unit exceeds its fair value, an
impairment loss is recognized for any excess of the carrying amount of the reporting
units goodwill over the implied fair value of that goodwill. The implied fair value of
goodwill is determined by allocating the fair value of the reporting unit in a manner
similar to a purchase price allocation, in accordance with SFAS No. 141,
Business
Combinations.
The residual fair value after this allocation is the implied fair value of
the reporting unit goodwill.
(o)
Use of Estimates
The preparation of the consolidated financial statements in conformity with U.S. GAAP
requires the Company to make a number of estimates and assumptions relating to the
reported amounts of assets and liabilities and the disclosure of contingent assets and
liabilities at the date of the consolidated financial statements and the reported amounts
of revenue and expenses during the period. Actual results could differ from those
estimates. The most significant items on the consolidated balance
16
(Continued)
Table of Contents
sheets that involve a greater degree of accounting estimates and actuarial determinations
subject to changes in the future are the claim liabilities and the allowance for doubtful
receivables. As additional information becomes available (or actual amounts are
determinable), the recorded estimates will be revised and reflected in operating results.
Although some variability is inherent in these estimates, the Company believes the
amounts provided are adequate.
(p)
Fair Value of Financial Instruments
Financial instruments that potentially subject the Company to concentrations of credit
risk consist principally of investments in corporate bonds, premiums receivable, accrued
interest receivable, and other receivables.
The fair value information of financial instruments in the accompanying consolidated
financial statements was determined as follows:
(i)
Cash and Cash Equivalents
The carrying amount approximates fair value because of the short-term nature of
such instruments.
(ii)
Investment in Securities
The fair value of investment securities is estimated based on quoted market prices
for those or similar investments. Additional information pertinent to the estimated
fair value of investment in securities is included in note 4.
(iii)
Receivables, Accounts Payable, and Accrued Liabilities
The carrying amount of receivables, accounts payable, and accrued liabilities
approximates fair value because they mature and should be collected or paid within
12 months after December 31.
(iv)
Annuity Contracts
The fair value of annuity contracts is the amount payable on demand at the
reporting date, and accordingly, the carrying value amount approximates fair value.
(v)
Short-term Borrowings
The carrying amount of securities sold under agreements to repurchase is a
reasonable estimate of fair value due to its short-term nature.
17
(Continued)
Table of Contents
(vi)
Long-term Borrowings
The carrying amounts and fair value of the Companys long-term borrowings are as
follows:
2005
2004
Carrying
Fair
Carrying
Fair
amount
value
amount
value
$
40,590
40,590
45,730
45,730
50,000
49,546
50,000
50,000
60,000
60,000
$
150,590
150,136
95,730
95,730
The carrying amount of the loans payable to bank approximates fair value due
to its floating interest-rate structure. The fair value of the senior unsecured
notes payable was determined using market quotations. Additional information
pertinent to long-term borrowings is included in note 11.
(vii)
Derivative Instruments
Current market pricing models were used to estimate fair value of interest-rate
swap agreement and structured notes agreements. Fair values were determined using
market quotations provided by outside securities consultants or prices provided by
market makers. Additional information pertinent to the estimated fair value of
derivative instruments is included in note 12.
(q)
Earnings Per Share
The Company calculates and presents earnings per share in accordance with SFAS No. 128,
Earnings per Share.
Basic earnings per share exclude dilution and are computed by
dividing the net income available to common stockholders by the weighted average number
of common shares outstanding for the period (see note 22). There is no potential dilution
that could affect basic earnings per share.
(r)
Recently Issued Accounting Standards
In December 2004, the FASB issued SFAS No. 153,
Exchanges of Nonmonetary Assets
, which
eliminates an exception in APB 29 for recognizing nonmonetary exchanges of similar
productive assets at fair value and replaces it with an exception for recognizing
exchanges of nonmonetary assets at fair value that do not have commercial substance. This
statement will be effective for the Company for nonmonetary asset exchanges occurring on
or after January 1, 2006. The adoption of this Statement is not expected to have any
impact on the Companys consolidated financial statements.
In May 2005, the FASB issued SFAS No. 154,
Accounting Changes and Error Corrections
. SFAS
No. 154 establishes, unless impracticable, retrospective application as the required
method for
18
(Continued)
Table of Contents
reporting a change in accounting principle in the absence of explicit
transition requirements specific to a newly adopted accounting principle. This statement
will be effective for the Company for any accounting changes and error corrections
occurring after January 1, 2006.
(s)
Reclassification
Certain amounts in the 2004 and 2003 financial statements were reclassified to conform
with the 2005 presentation.
(3)
Segment Information
The operations of the Company are conducted principally through four business segments.
Business segments were identified according to the type of insurance products offered. These
segments and a description of their respective operations are as follows:
Health Insurance
-
Commercial Program
-TSI is engaged in three principal underwriting
activities, which are its Commercial Plan, the Reform Program, and the Federal Employees
Health Benefits Program (FEHBP). The insurance coverage of the Health Insurance -
Commercial Program is provided by TSI and comprises the health insurance coverage
subscribed to all commercial groups and some government entities. The Reform Program is
considered a separate segment and is described in the following paragraph. The Commercial
Program offers a fee-for-service type plan through five distinct markets: corporate
sector; individual sector; local government sector, covering the employees of the
Commonwealth of Puerto Rico; federal government program, covering federal government
employees within Puerto Rico; Medicare Advantage; and the Medicare supplement plan
(Medigap). The premiums for this segment are mainly originated through TSIs internal
sales force and a network of brokers and independent agents. TSI is a qualified
contractor to provide health insurance coverage to federal government employees within
Puerto Rico. The contract with the U.S. Office of Personnel Management (OPM) is subject
to termination in the event of noncompliance not corrected to the satisfaction of OPM
(see note 9). Under its Commercial Program, TSI provides health insurance coverage to
certain employees of the Commonwealth of Puerto Rico and its instrumentalities. Earned
premium revenue related to such health plans amounted to $64,623, $67,082, and $65,947
for the three-year period ended December 31, 2005, 2004, and 2003, respectively. TSI also
processes and pays claims as fiscal intermediary for the Medicare Part B Program in
Puerto Rico and is reimbursed for operating expenses (see note 15).
Health Insurance
-
Reform Program
- This type of insurance is also provided by TSI and
the business subscribed within this segment is awarded periodically by the Commonwealth
of Puerto Ricos central government. The Reform program provides health coverage to
medically indigent citizens in Puerto Rico, as defined by the laws of the Commonwealth of
Puerto Rico. The Reform consists of a single policy with the same benefits for each
qualified medically indigent citizen. The government segregates Puerto Rico by areas or
regions. Each area is awarded to an insurance company through a bidding process.
Commencing on July 1, 2002, TSI was awarded three of the eight geographical areas: North,
Metro-North, and Southwest. All Reform contracts are subject to termination, with a prior
written notice of 90 days, in the event of noncompliance not corrected or cured to the
satisfaction of the Commonwealth of Puerto Rico or in the event the government determines
that there are not enough funds for the payment of premiums. In addition, the Reform
19
(Continued)
Table of Contents
contracts stipulate that in the event that the net income for any given contract year, as
defined, exceeds 2.5% of the premiums collected for the related contract year, TSI,
through the Reform program, would need to return 75% of this excess to the Government of
Puerto Rico.
Property and Casualty Insurance
- This type of insurance is provided by STS. The
predominant insurance lines of business of this segment are commercial multiple peril,
auto physical damage, auto liability, and dwelling. The premiums for this segment are
originated through a network of independent insurance agents and brokers. Agents or
general agencies collect the premiums from the insureds, which are subsequently remitted
to STS, net of commissions. Remittances are due 60 days after the closing date of the
general agents account current.
Life and Disability Insurance
- This type of insurance is provided by SVTS, which
offers primarily group life, group short- and long-term disability insurance coverage,
and the administration of individual retirement accounts and annuities. The premiums for
this segment are mainly subscribed through a network of brokers and independent agents.
SVTS has a coinsurance funds withheld agreement with Great American Life Assurance
Company of Puerto Rico (GA Life). Under the terms of this agreement SVTS assumes 69% of
the business written of GA Life (see note 16).
The Companys Life and Disability Insurance segment met one of the quantitative thresholds
determined by SFAS No. 131,
Disclosures about Segments of an Enterprise and Related
Information
, that require separate disclosure of an operating segment. Thus, the Life and
Disability Insurance segment is presented as a reportable segment in the year ended December
31, 2005. The segment information for the years ended December 31, 2004 and 2003 has been
restated to present the results of operations and financial position of the Life and
Disability operating segment separate from the Companys other nonreportable operating
segments.
The accounting policies for the segments are the same as those described in the summary of
significant accounting policies included in the notes to consolidated financial statements.
The Company evaluates performance based primarily on the net income of each segment. Services
provided between reportable segments are done at transfer prices which approximate fair value.
The financial data of each segment is accounted for separately; therefore no segment
allocation is necessary. However, certain operating expenses are centrally managed, therefore
requiring an allocation to each segment. Most of these expenses are distributed to each
segment based on different parameters, such as payroll hours, processed claims, or square
footage, among others. In addition, some depreciable assets are kept by one segment, while
allocating the depreciation expense to other segments. The allocation of the depreciation
expense is based on the proportion of asset use by each segment. Certain expenses are not
allocated to the segments and are kept within TSMs operations.
The following tables summarize the operations by operating segment for the three-year period
ended December 31, 2005, 2004, and 2003.
20
(Continued)
Table of Contents
2005
Operating segment
Health
Insurance
Insurance
Property
Life and
Commercial
Reform
and Casualty
Disability
Program
Program
Insurance
Insurance
Other *
Total
$
765,468
510,839
86,767
17,130
1,380,204
210,905
210,905
(196,460
)
(196,460
)
4,274
50,004
54,278
784,187
510,839
86,767
17,130
50,004
1,448,927
13,904
2,945
8,706
3,018
28,573
5,936
(86
)
1,243
68
7,161
(4,388
)
(298
)
(23
)
(4,709
)
3,258
(20
)
169
189
3,596
$
802,897
513,678
96,587
20,382
50,004
1,483,548
$
15,384
(43
)
9,863
2,098
302
27,604
677,870
478,008
43,587
8,902
1,208,367
103,562
36,432
39,642
8,201
49,461
237,298
2,963
677
439
62
4,141
4,510
970
1,323
6,803
1,571
(1,689
)
3,495
(142
)
241
3,476
459,288
82,685
307,228
271,615
4,310
1,125,126
(12,432
)
(1,301
)
(3,090
)
(1,844
)
(18,667
)
(2,048
)
(142
)
(76
)
(453
)
(2,719
)
*
Includes segments which are not required to be reported separately. These segments include the data processing services organization
as well as the third-party administrator of health insurance services.
21
(Continued)
Table of Contents
2004
Operating segment
Health
Insurance
Insurance
Property
Life and
Commercial
Reform
and Casualty
Disability
Program
Program
Insurance
Insurance
Other *
Total
$
711,547
484,742
86,228
16,442
1,298,959
179,166
179,166
(169,924
)
(169,924
)
3,945
47,971
51,916
724,734
484,742
86,228
16,442
47,971
1,360,117
12,590
3,109
7,668
2,778
26,145
9,040
128
1,087
713
10,968
1,879
801
362
3,042
269
(30
)
2,675
240
3,154
$
748,512
487,949
98,459
20,535
47,971
1,403,426
$
23,757
9,250
11,085
996
363
45,451
620,751
437,834
45,977
11,231
1,115,793
94,930
35,777
40,182
7,347
46,856
225,092
2,841
789
418
177
4,225
1,928
428
4
1,004
3,364
7,146
4,660
1,211
(43
)
752
13,726
443,710
84,627
282,393
87,135
3,578
901,443
523
(151
)
867
(156
)
1,083
313
(60
)
(49
)
(265
)
(61
)
*
Includes segments which are not required to be reported separately. These segments include the data processing services organization
as well as the third-party administrator of health insurance services.
22
(Continued)
Table of Contents
2003
Operating segment
Health
Insurance
Insurance
Property
Life and
Commercial
Reform
and Casualty
Disability
Program
Program
Insurance
Insurance
Other *
Total
$
691,044
477,614
78,334
17,403
1,264,395
160,127
160,127
(151,806
)
(151,806
)
3,488
45,989
49,477
702,853
477,614
78,334
17,403
45,989
1,322,193
10,734
4,476
6,824
2,345
24,379
6,345
53
722
595
7,715
11,157
1,848
2,045
(157
)
14,893
196
(30
)
4,154
74
4,394
$
731,285
483,961
92,079
20,260
45,989
1,373,574
$
49,071
14,034
9,677
3,716
1,238
77,736
584,448
428,045
43,390
9,467
1,065,350
92,264
34,637
37,354
6,036
44,538
214,829
3,106
945
423
120
5
4,599
862
366
721
1,949
4,640
6,879
1,658
320
213
13,710
407,031
86,535
239,478
72,475
2,055
807,574
(5,226
)
(527
)
220
(5,533
)
2,385
(23
)
(8
)
(47
)
2,307
*
Includes segments which are not required to be reported separately. These segments include the data processing services organization
as well as the third-party administrator of health insurance services.
23
(Continued)
Table of Contents
2005
2004
2003
$
1,433,544
1,355,455
1,327,585
50,004
47,971
45,989
1,483,548
1,403,426
1,373,574
(4,274
)
(3,945
)
(3,488
)
(50,004
)
(47,971
)
(45,989
)
592
560
1,259
(53,686
)
(51,356
)
(48,218
)
$
1,429,862
1,352,070
1,325,356
2005
2004
2003
$
27,302
45,088
76,498
302
363
1,238
27,604
45,451
77,736
6,588
6,084
6,283
1,353
734
658
7,941
6,818
6,941
(5,271
)
(4,787
)
(6,080
)
(288
)
(288
)
(51,687
)
(2,145
)
(1,951
)
(1,940
)
592
560
1,259
(7,112
)
(6,466
)
(58,448
)
$
28,433
45,803
26,229
Table of Contents
2005
2004
$
1,120,816
897,865
4,310
3,578
1,125,126
901,443
(28,705
)
(21,717
)
11,054
12,236
24,760
25,577
5,227
2,118
41,041
39,931
$
1,137,462
919,657
2005
Segment
Consolidated
Other significant items
totals
Adjustments (*)
totals
$
1,208,367
1,208,367
237,298
(55,595
)
181,703
4,141
1,089
5,230
6,803
792
7,595
3,476
288
3,764
(18,667
)
(165
)
(18,832
)
(2,719
)
(69
)
(2,788
)
2004
Segment
Consolidated
Other significant items
totals
Adjustments (*)
totals
$
1,115,793
1,115,793
225,092
(53,213
)
171,879
4,225
1,118
5,343
3,364
1,217
4,581
13,726
288
14,014
1,083
18
1,101
(61
)
58
(3
)
2003
Segment
Consolidated
Other significant items
totals
Adjustments (*)
totals
$
1,065,350
1,065,350
214,829
(49,680
)
165,149
4,599
1,110
5,709
1,949
1,282
3,231
13,710
51,687
65,397
(5,533
)
(489
)
(6,022
)
2,307
(15
)
2,292
*
Adjustments represent principally TSM operations and eliminations of intersegment charges.
Table of Contents
(4)
Investment in Securities
The amortized cost for debt and equity securities, gross unrealized gains, gross unrealized
losses, and estimated fair value for trading, available-for-sale, and held-to-maturity
securities by major security type and class of security at December 31, 2005 and 2004, were as
follows:
2005
Gross
Gross
Amortized
unrealized
unrealized
Estimated
cost
gains
losses
fair value
$
69,397
11,378
(2,560
)
78,215
2004
Gross
Gross
Amortized
unrealized
unrealized
Estimated
cost
gains
losses
fair value
$
23,978
601
(41
)
24,538
46,690
1,444
(249
)
47,885
70,668
2,045
(290
)
72,423
74,824
13,496
(1,724
)
86,596
$
145,492
15,541
(2,014
)
159,019
Table of Contents
2005
Gross
Gross
Amortized
unrealized
unrealized
Estimated
cost
gains
losses
fair value
$
426,391
21
(7,754
)
418,658
55,388
522
(1,304
)
54,606
6,535
61
(104
)
6,492
4,667
58
(58
)
4,667
31,306
32
(587
)
30,751
524,287
694
(9,807
)
515,174
38,675
14,550
(1,415
)
51,810
$
562,962
15,244
(11,222
)
566,984
Table of Contents
2004
Gross
Gross
Amortized
unrealized
unrealized
Estimated
cost
gains
losses
fair value
$
337,045
1,012
(967
)
337,090
62,331
1,231
(971
)
62,591
500
2
502
5,771
48
(3
)
5,816
12,430
160
(43
)
12,547
26,058
206
(173
)
26,091
444,135
2,659
(2,157
)
444,637
34,309
24,913
(36
)
59,186
$
478,444
27,572
(2,193
)
503,823
2005
Gross
Gross
Amortized
unrealized
unrealized
Estimated
cost
gains
losses
fair value
$
5,993
(143
)
5,850
4,282
(79
)
4,203
9,693
(401
)
9,292
161
161
1,000
254
1,254
$
21,129
254
(623
)
20,760
Table of Contents
2004
Gross
Gross
Amortized
unrealized
unrealized
Estimated
cost
gains
losses
fair value
$
5,991
24
6,015
5,126
4
(22
)
5,108
2,007
(2
)
2,005
156
156
1,000
219
1,219
$
14,280
247
(24
)
14,503
Table of Contents
2005
Less than 12 months
12 months or longer
Total
Gross
Gross
Gross
Estimated
unrealized
Estimated
unrealized
Estimated
unrealized
fair value
losses
fair value
losses
fair value
losses
$
243,470
(3,683
)
161,654
(4,071
)
405,124
(7,754
)
2,886
(113
)
35,368
(1,191
)
38,254
(1,304
)
2,391
(44
)
1,944
(60
)
4,335
(104
)
3,174
(58
)
3,174
(58
)
14,725
(227
)
14,457
(360
)
29,182
(587
)
263,472
(4,067
)
216,597
(5,740
)
480,069
(9,807
)
13,359
(1,288
)
3,059
(127
)
16,418
(1,415
)
$
276,831
(5,355
)
219,656
(5,867
)
496,487
(11,222
)
$
5,850
(143
)
5,850
(143
)
598
(2
)
3,605
(77
)
4,203
(79
)
9,292
(401
)
9,292
(401
)
$
15,740
(546
)
3,605
(77
)
19,345
(623
)
Table of Contents
2004
Less than 12 months
12 months or longer
Total
Gross
Gross
Gross
Estimated
unrealized
Estimated
unrealized
Estimated
unrealized
fair value
losses
fair value
losses
fair value
losses
$
79,145
(368
)
70,249
(599
)
149,394
(967
)
15,648
(415
)
19,129
(556
)
34,777
(971
)
497
(3
)
497
(3
)
4,649
(32
)
3,311
(11
)
7,960
(43
)
9,493
(94
)
6,997
(79
)
16,490
(173
)
108,935
(909
)
100,183
(1,248
)
209,118
(2,157
)
2,416
(20
)
2,734
(16
)
5,150
(36
)
$
111,351
(929
)
102,917
(1,264
)
214,268
(2,193
)
$
2,138
(13
)
2,131
(9
)
4,269
(22
)
2,005
(2
)
2,005
(2
)
$
4,143
(15
)
2,131
(9
)
6,274
(24
)
Table of Contents
Amortized
Estimated
cost
fair value
$
21,620
21,432
282,175
277,316
160,031
157,146
24,488
23,862
31,306
30,751
4,667
4,667
$
524,287
515,174
$
161
161
8,998
9,048
7,688
7,348
4,282
4,203
$
21,129
20,760
Investments with a face value of $1,885 and $1,800 (fair value of $1,832 and $1,792)
at December 31, 2005 and 2004, respectively, were held as collateral for the short-term
borrowings of the Company (see note 10).
Investments with a face value of $500 and $2,010 (fair value of $480 and $1,979) at
December 31, 2005 and 2004, respectively, were held as collateral for the Companys
interest-rate swap agreement (see note 12).
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Information regarding realized and unrealized gains and losses from investments for the years
ended December 31, 2005, 2004, and 2003 is as follows:
2005
2004
2003
$
2,235
594
1,480
(542
)
(492
)
(257
)
1,693
102
1,223
137
123
971
(214
)
(241
)
(632
)
(77
)
(118
)
339
1,616
(16
)
1,562
6,339
5,608
2,739
(1,776
)
(1,056
)
(6,529
)
4,563
4,552
(3,790
)
2,043
6,432
10,593
(1,061
)
982
6,432
10,593
5,545
10,984
6,803
$
7,161
10,968
8,365
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2005
2004
2003
$
(1,755
)
(7
)
(1,068
)
(2,954
)
3,049
15,961
$
(4,709
)
3,042
14,893
$
(9,615
)
(1,481
)
(3,783
)
(11,742
)
2,714
(4
)
$
(21,357
)
1,233
(3,787
)
$
(592
)
110
119
Deferred tax liability on unrealized gains and losses recognized in accumulated other
comprehensive income during the years 2005, 2004, and 2003 aggregated $805, $3,330, and
$3,198, respectively.
As of December 31, 2005, investments in obligations that are payable from and secured by the
same source of revenue or taxing authority, other than investment instruments of the U.S. and
the Commonwealth of
Puerto Rico governments, did not exceed 10% of stockholders equity. As of December 31, 2005,
no investment in equity securities individually exceeded 10% of stockholders equity.
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Components of net investment income were as follows:
Year ended December 31
2005
2004
2003
$
21,691
20,108
16,443
1,415
1,023
1,495
988
930
2,367
553
428
731
2,821
2,799
2,385
72
1,670
1,532
1,434
29,138
26,820
24,927
109
321
248
$
29,029
26,499
24,679
Premium and other receivables as of December 31 were as follows:
2005
2004
$
53,391
45,451
21,620
17,717
9,491
9,346
5,074
5,080
118,635
33,915
30,496
14,152
16,406
256,278
124,496
7,792
6,456
4,448
4,717
12,240
11,173
$
244,038
113,323
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Property and equipment as of December 31 are composed of the following:
2005
2004
$
6,531
6,531
35,860
33,272
11,937
10,298
26,130
24,867
239
250
80,697
75,218
45,988
42,854
$
34,709
32,364
The activity in the total claim liabilities during 2005, 2004, and 2003 is as follows:
2005
2004
2003
$
279,325
247,920
244,582
(26,555
)
(19,357
)
(13,589
)
252,770
228,563
230,993
1,195,066
1,112,325
1,081,570
13,301
3,468
(16,220
)
1,208,367
1,115,793
1,065,350
1,004,060
920,173
906,098
188,234
171,413
161,682
1,192,294
1,091,586
1,067,780
268,843
252,770
228,563
28,720
26,555
19,357
$
297,563
279,325
247,920
As a result of differences between actual amounts and estimates of insured events in prior
years, the amounts included as incurred claims for prior period insured events differ from
anticipated claims incurred.
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The amount of incurred claims and loss-adjustment expenses for prior period insured events for
the years 2005 and 2004 are due to higher than expected cost per service and utilization
trends. The credit in the incurred claims and loss-adjustment expenses for prior period
insured events for the year 2003 is due primarily to better than expected utilization trends.
Reinsurance recoverable on unpaid claims is reported as premium and other receivables, net in
the accompanying consolidated financial statements.
TSI entered into a contract, renewable annually, with OPM as authorized by the Federal
Employees Health Benefits Act of 1959, as amended, to provide health benefits under the
FEHBP. The FEHBP covers postal and federal employees resident in the Commonwealth of Puerto
Rico as well as retirees and eligible dependents. The FEHBP is financed through a negotiated
contribution made by the federal government and employees payroll deductions.
The accounting policies for the FEHBP are the same as those described in the Companys summary
of significant accounting policies. Premium rates are determined annually by TSI and approved
by the federal government. Claims are paid to providers based on the guidelines determined by
the federal government. Operating expenses are allocated from TSIs operations to the FEHBP
based on applicable allocation guidelines (such as, the number of claims processed for each
program).
The operations of the FEHBP do not result in any excess or deficiency of revenue or expense as
this program has a special account available to compensate any excess or deficiency on its
operations to the benefit or detriment of the federal government. Any transfer to/from the
special account necessary to cover any excess or deficiency in the operations of the FEHBP is
recorded as a reduction/increment to the premiums earned. The contract with OPM provides that
the cumulative excess of the FEHBP earned income over health benefits charges and expenses
represents a restricted fund balance denoted as the special account. Upon termination of the
contract and satisfaction of all the FEHBPs obligations, any unused remainder of the special
reserve would revert to the Federal Employees Health Benefit Fund. In the event that the
contract terminates and the special reserve is not sufficient to meet the FEHBPs obligations,
the FEHBP contingency reserve will be used to meet such obligations. If the contingency
reserve is not sufficient to meet such obligations, the Company is at risk for the amount not
covered by the contingency reserve.
The contract with OPM allows for the payment of service fees as negotiated between TSI and
OPM. Service fees, which are included within the other income, net in the accompanying
consolidated statements of earnings, amounted to $800, $778, and $626, respectively, for each
of the years in the three-year period ended December 31, 2005.
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The following summarizes the operations of the FEHBP for each of the years in the three-year
period ended December 31, 2005:
2005
2004
2003
$
106,687
105,246
91,241
6,494
2,897
12,618
113,181
108,143
103,859
107,624
102,126
97,428
5,318
5,521
6,054
112,942
107,647
103,482
$
239
496
377
$
561
282
249
(800
)
(778
)
(626
)
$
(239
)
(496
)
(377
)
The changes in the special account during 2005 and 2004 are as follows:
2005
2004
$
9,791
7,471
(6,494
)
(2,897
)
1,059
5,217
$
4,356
9,791
The account for the FEHBP is related to the following accounts in the consolidated balance
sheets as of December 31, 2005 and 2004:
2005
2004
$
14,368
17,154
9,550
9,381
(9,842
)
(9,920
)
(9,720
)
(6,824
)
$
4,356
9,791
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A contingency reserve is maintained by the OPM at the U.S. Treasury, and is available to the
Company under certain conditions as specified in government regulations. Accordingly, such
reserve is not reflected in the accompanying balance sheets. The balance of such reserve as of
December 31, 2005 and 2004 was $19,353 and $18,415, respectively. The Company received $1,059,
$5,217, and $13,023, of payments made from the contingency reserve fund of OPM during 2005,
2004, and 2003, respectively.
The claim payments and operating expenses charged to the FEHBP are subject to audit by the
U.S. government. Management is of the opinion that an adjustment, if any, resulting from such
audits will not have a significant effect on the accompanying financial statements. The claim
payments and operating expenses reimbursed in connection with the FEHBP have been audited
through 1998 by OPM.
Short-term borrowings of $1,740 and $1,700 at December 31, 2005 and 2004, respectively,
represent securities sold under agreements to repurchase. The agreement outstanding at
December 31, 2005 matures in January 2006 and accrues interest at London Interbank Offered
Rate (LIBOR) (interest rate of 4.45%).
The investment securities underlying such agreements were delivered to the dealers with whom
the agreements were transacted. The dealers may have sold, loaned, or otherwise disposed of
such securities in the normal course of business operations, but have agreed to resell to the
Company substantially the same securities on the maturity dates of the agreements.
At December 31, 2005 and 2004, investment securities available for sale with fair value of
$1,832 and $1,792 (face value of $1,885 and $1,800) were pledged as collateral under these
agreements.
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A summary of long-term borrowings entered by the Company at December 31, 2005 and 2004 is as
follows:
2005
2004
$
11,500
15,000
50,000
50,000
60,000
29,090
30,730
$
150,590
95,730
Aggregate maturities of the Companys long-term borrowings as of December 31, 2005 are
summarized as follows:
$
1,640
13,140
1,640
1,640
1,640
130,890
$
150,590
As of December 31, 2005, the Company has the following senior unsecured notes payable:
6.30% senior unsecured notes payable of $50,000 due on September 2019 (the 6.30%
notes). These notes were issued on September 30, 2004 and are unconditionally guaranteed
as to payment of
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principal, premium, if any, and interest by the Company. The 6.30% notes
were privately placed to various institutional investors under a note purchase agreement
between TSI, the Company, and the investors. Debt issuance costs amounting to $600 were
deferred and will be amortized using the straight-line method over the term of the 6.30%
notes. These notes can be prepaid after five years at par, in total or partially, as
determined by the Company.
6.60% senior unsecured notes payable of $60,000 due on December 2020 (the 6.60%
notes). These notes were issued on December 21, 2005. Debt issuance costs amounting to
$580 were deferred and will be amortized using the straight-line method over the term of
the 6.60% notes. These notes can be prepaid after five years at par, in total or
partially, as determined by the Company.
Both the 6.30% and the 6.60% senior unsecured notes contain certain covenants with which TSI
and the Company have complied with at December 31, 2005.
Unamortized debt issuance costs related to the 6.30% and the 6.60% senior unsecured notes as
of December 31, 2005 and 2004 amounted to $1,129 and $589, respectively, and are included
within the other assets in the accompanying consolidated balance sheets.
The credit agreement related to the $20,000 secured note payable calls for repayments of
principal amount of not less than $250 and in integral multiples of $50. The aggregate
principal amounts shall be reduced annually to the amounts specified on or before the dates
described below:
Required
principal
outstanding
Date
balance
$
12,000
The loan and note payable previously described are guaranteed by a first position held by the
bank on the Companys land, building, and substantially all leasehold improvements, as
collateral for the term of the loans under a continuing general security agreement. These
credit facilities contain certain covenants, which are normal in this type of credit facility,
which the Company has complied with at December 31, 2005 and 2004.
Interest expense on the above long-term borrowings amounted to $5,168, $2,005, and $1,302 for
the years ended December 31, 2005, 2004, and 2003, respectively.
The Company uses derivative instruments to manage the risks associated with changes in
interest rates and to diversify the composition of its investment in securities.
By using derivative financial instruments the Company exposes itself to credit risk and market
risk. Credit risk is the failure of the counterparty to perform under the terms of the
derivative contract. When the fair
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value of a derivative contract is positive, the
counterparty is obligated to the Company, which creates credit risk for the Company. When the
fair value of a derivative contract is negative, the Company owes the counterparty and,
therefore, it does not possess credit risk. The Company minimizes the credit risk in
derivative instruments by entering into transactions with high-quality counterparties.
Market risk is the adverse effect on the value of a financial instrument that results from a
change in interest rates, currency exchange rates, commodity prices, or market indexes. The
market risk associated with derivative instruments is managed by establishing and monitoring
parameters that limit the types and degree of market risk that may be undertaken.
(a)
Cash Flow Hedge
The Company has invested in an interest-rate related derivative hedging instrument to
manage its exposure on its debt instruments.
The Company assesses interest rate cash flow risk by continually identifying and
monitoring changes in interest rate exposures that may adversely impact expected future
cash flows and by evaluating
hedging opportunities. The Company maintains risk management control systems to monitor
interest rate cash flow risk attributable to both the Companys outstanding or forecasted
debt obligations as well as the Companys offsetting hedge positions. The risk management
control systems involve the use of analytical techniques to estimate the expected impact
of changes in interest rates on the Companys future cash flows.
The Company has a variable-rate debt that was used to finance the acquisition of real
estate from subsidiaries (see note 11). The debt obligations expose the Company to
variability in interest payments due to changes in interest rates. Management believes it
is prudent to limit the variability of a portion of its interest payments. To meet this
objective, on December 6, 2002, management entered into an interest-rate swap agreement,
with an effective date of April 1, 2003, to manage fluctuations in cash flows resulting
from interest rate risk. The maturity date of the interest-rate swap agreement is March
30, 2008. This swap economically changes the variable-rate cash flow exposure on the debt
obligations to fixed cash flows. Under the terms of the interest-rate swap, the Company
receives variable interest rate payments and makes fixed interest rate payments, thereby
creating the equivalent of fixed-rate debt.
Changes in the fair value of the interest-rate swap, designated as a hedging instrument
that effectively offsets the variability of cash flows associated with the variable-rate
of the long-term debt obligation, are reported in accumulated other comprehensive income,
net of the related tax effect. This amount is subsequently reclassified into interest
expense as a yield adjustment of the hedged debt obligation in the same period in which
the related interest affects earnings. During the years ended December 31, 2005 and 2004,
the Company recorded $127 and $734 of interest expense related to this agreement. No
amount representing cash-flow hedge ineffectiveness was recorded since the terms of the
swap agreement allow the Company to assume no ineffectiveness in the agreement.
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As of December 31, 2005, the fair market value of the interest rate swap amounted to $607
and was included within the other assets in the accompanying consolidated balance sheets.
As of December 31, 2004, the fair market value of the interest-rate swap amounted to $142
and was included within the accounts payable and accrued liabilities in the accompanying
consolidated balance sheets. There were no cash-flow hedges discontinued during 2005.
(b)
Other Derivative Instruments
The Company has invested in other derivative instruments in order to diversify its
investment in securities and participate in the foreign stock market.
During 2005 the Company invested in two structured note agreements amounting to $5,000
each, where the interest income received is linked to the performance of the Dow Jones
Euro STOXX 50 and Nikkei 225 Equity Indexes (the Indexes). Under these agreements the
principal invested by the Company is protected, the only amount that varies according to
the performance of the Indexes is the interest to be received upon the maturity of the
instruments. Should the Indexes experience a negative performance during the holding
period of the structured notes, no interest will be received and no amount will be paid
to the issuer of the structured notes. The contingent interest payment
component within the structured note agreements meets the definition of an embedded
derivative. In accordance with the provisions of SFAS No. 133, as amended, the embedded
derivative component of the structured notes is separated from the structured notes and
accounted for separately as a derivative instrument.
The changes in the fair value of the embedded derivative component are recorded as gains
or losses in earnings in the period of change. During the year ended December 31, 2005
the Company recorded a gain associated with the change in the fair value of this
derivative component of $2,833 that is included within the other income, net of the
consolidated statement of earnings.
As of December 31, 2005, the fair value of the derivative component of the structured
notes amounted to $5,331 and is included within the Companys other assets in the
consolidated balance sheets. The investment component of the structured notes is
accounted for as held-to-maturity debt securities and is included within the investment
in securities in the consolidated balance sheets. As of December 31, 2005 the fair value
and amortized cost of the investment component of both structured notes amounted to
$7,348 and $7,688, respectively.
As members of the BCBSA, the Company and TSI are required by membership standards of the
association to maintain liquidity as defined by BCBSA. That is, to maintain net worth
exceeding the Company Action Level as defined in the National Association of Insurance
Commissioners (NAIC) Risk-Based Capital for Insurers Model Act. The companies are in
compliance with this requirement.
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The accumulated balances for each classification of comprehensive income are as follows:
Accumulated
Unrealized
Minimum
other
gains on
pension
Cash-flow
comprehensive
securities
liability
hedges
income
$
22,049
(5,825
)
(86
)
16,138
(18,102
)
(2,788
)
457
(20,433
)
(730
)
(730
)
$
3,217
(8,613
)
371
(5,025
)
2005
Deferred tax
Before-tax
(expense)
Net-of-tax
amount
benefit
amount
$
(20,452
)
2,350
(18,102
)
(905
)
175
(730
)
(21,357
)
2,525
(18,832
)
(4,515
)
1,727
(2,788
)
749
(292
)
457
$
(25,123
)
3,960
(21,163
)
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2004
Deferred tax
Before-tax
(expense)
Net-of-tax
amount
benefit
amount
$
7,547
451
7,998
(6,314
)
(583
)
(6,897
)
1,233
(132
)
1,101
35
(38
)
(3
)
459
(178
)
281
$
1,727
(348
)
1,379
2003
Deferred tax
Before-tax
(expense)
Net-of-tax
amount
benefit
amount
$
7,145
(3,575
)
3,570
(10,932
)
1,340
(9,592
)
(3,787
)
(2,235
)
(6,022
)
(681
)
2,973
2,292
81
22
103
$
(4,387
)
760
(3,627
)
TSI processes and pays claims as fiscal intermediary for the Medicare Part B Program. Claims
from this program, which are excluded from the accompanying consolidated statements of
earnings, amounted to $618,725, $625,841, and $579,300 for each of the years in the three-year
period ended December 31, 2005.
TSI is reimbursed for administrative expenses incurred in performing this service. For the
years ended December 31, 2005, 2004, and 2003, TSI was reimbursed by $13,886, $13,980, and
$11,387, respectively, for such services which are deducted from operating expenses in the
accompanying consolidated statements of earnings.
The operating expense reimbursements in connection with processing Medicare claims have been
audited through 1997 by federal government representatives. Management is of the opinion that
no significant adjustments will be made affecting cost reimbursements through December 31,
2005.
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(16)
Reinsurance Activity
The effect of reinsurance on premiums earned and claims incurred is as follows:
Premiums earned
Claims incurred
2005
2004
2003
2005
2004
2003
$
1,447,054
1,359,140
1,315,981
1,225,065
1,133,238
1,080,207
(67,250
)
(60,181
)
(51,586
)
(16,698
)
(17,445
)
(14,857
)
400
$
1,380,204
1,298,959
1,264,395
1,208,367
1,115,793
1,065,350
(a)
Reinsurance Ceded Activity
STS and SVTS, in accordance with general industry practices, annually purchase
reinsurance to protect them from the impact of large unforeseen losses and prevent sudden
and unpredictable changes in net income and stockholders equity of the Company.
Reinsurance contracts do not relieve any of the subsidiaries from their obligations to
policyholders. In the event that all or any of the reinsuring companies might be unable
to meet their obligations under existing reinsurance agreements, the subsidiaries would
be liable for such defaulted amounts. During 2005 and 2004, STS placed 9% of its
reinsurance business with one reinsurance company.
STS has a number of pro rata and excess of loss reinsurance treaties whereby the
subsidiary retains for its own account all loss payments for each occurrence that does
not exceed the stated amount in the agreements and a catastrophe cover, whereby it
protects itself from a loss or disaster of a
catastrophic nature. Under these treaties, STS ceded premiums of $59,244, $52,214, and
$43,770 in 2005, 2004, and 2003, respectively.
Reinsurance cessions are made on excess of loss and on a proportional basis. Principal
reinsurance agreements are as follows:
Property quota share treaty covering for a maximum of $20,000 for any one risk.
Only 42.5% of this treaty was placed with reinsurers. The remaining exposure was
covered by a property per risk excess of loss treaty, which provides reinsurance in
excess of $500 up to a maximum of $12,500 or the remaining 57.5% for any one risk.
STS also has an additional property catastrophe excess of loss contract, which
provides protection for losses in excess of $5,000 resulting from any catastrophe,
subject to a maximum loss of $10,000.
Personal property catastrophe excess of loss. This treaty provides protection for
losses in excess of $5,000 resulting from any catastrophe, subject to a maximum loss
of $100,000.
Commercial property catastrophe excess of loss. This treaty provides protection
for losses in excess of $5,000 resulting from any catastrophe, subject to a maximum
loss of $180,000.
Property catastrophe excess of loss. This treaty provides protection for losses
in excess of $110,000 and $180,000 with respect to personal and commercial lines,
respectively, resulting from any catastrophe, subject to a maximum loss of $90,000.
46
(Continued)
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Personal lines quota share. This treaty provides protection of 10.0% on all
ground-up losses, subject to a limit of $1,000 for any one risk.
Reinstatement premium protection. This treaty provides a maximum limit of $2,200
in personal lines and $5,200 in commercial lines to cover the necessity of
reinstating the catastrophe program in the event it is activated.
Casualty excess of loss treaty. This treaty provides reinsurance for losses in
excess of $150 up to a maximum of $11,850.
Medical malpractice excess of loss. This treaty provides reinsurance in excess of
$150 up to a maximum of $1,500 per incident.
Builders risk quota share and first surplus covering contractors risk. This
treaty provides protection on a 20/80 quota share basis for the initial $2,500 and a
first surplus of $10,000 for a maximum of $12,000 for any one risk.
Surety quota share treaty covering contract and miscellaneous surety bond
business. This treaty provides reinsurance of up to $3,000 for contract surety
bonds, subject to an aggregate of $7,000 per contractor and $2,000 per miscellaneous
surety bond.
Facultative reinsurance is obtained when coverage per risk is required, on a proportional
basis. All reinsurance contracts are for a period of one year, on a calendar basis, and
are subject to modifications and negotiations in each renewal.
SVTS cedes insurance with seven reinsurers. Insurance is ceded on pro rata, facultative
excess of loss and catastrophic bases. Under the pro rata agreement, SVTS reinsures 50%
of the risk up to $250 on the life of any participating individual of certain groups
insured. Under this treaty, SVTS ceded premiums of $2,227 in 2005, $2,291 in 2004, and
$2,236 in 2003.
The life insurance facultative excess of loss agreements provide for SVTS to retain a
portion of the losses on the life of any participating individual of certain groups
insured. Any excess will be recovered from the reinsurer. This agreement provides for
various retentions ($25, $50, and $75) of the losses. Under this facultative treaty, SVTS
ceded premiums of approximately $982 in 2005, $908 in 2004, and $756 in 2003.
SVTS also has a facultative excess of loss agreements for the supplemental health
benefits insurance risk. This agreement provides for SVTS to retain $20 of the losses on
any participating individual. Any excess will be recovered from the reinsurer. Under this
facultative treaty, SVTS ceded premiums of approximately $44 and $3 in 2005 and 2004,
respectively. No premiums were ceded during the year 2003.
SVTS also has facultative pro rata agreements for the long-term disability insurance risk
as follows:
A long-term disability insurance treaty where SVTS reinsures 65% of the risk.
Premiums ceded under this agreement amount to $4,576, $4,521 and $4,507 in 2005,
2004, and 2003, respectively.
47
(Continued)
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A long-term disability insurance treaty where SVTS reinsures 75% of the risk.
Premiums ceded under this agreement amounted to $21, $118, and $133 during the years
2005, 2004, and 2003, respectively.
The accidental death catastrophic reinsurance covers each and every accident arising out
of one event or occurrence resulting in the death or dismemberment of five or more
persons. SVTSs retention for each event is $250 with a maximum of $1,000 for each event
and $2,000 per year. Under this treaty, the Company ceded premiums of $117 in 2005, $82
in 2004, and $90 in 2003.
The ceded unearned reinsurance premiums on STS arising from these reinsurance
transactions amounted to $17,475 and $13,751 at December 31, 2005 and 2004, respectively
and are reported as other assets in the accompanying consolidated balance sheets.
(b)
Reinsurance Assumed Activity
On December 22, 2005, SVTS entered into a coinsurance funds withheld agreement with GA
Life. Under the terms of this agreement SVTS will assume 69% of all the business written
as of and after the effective date of the agreement. On the effective date of the
agreement, SVTS paid an initial ceding commission of $60,000 for its participation in the
business written by GA Life as of and after the effective date of the agreement. This
amount is considered a policy acquisition cost and was deferred and will be amortized
accordingly.
As in other coinsurance funds withheld agreements, GA Life invests the premiums received
from policyholders, pays commissions, processes claims and engages in other
administrative activities. GA Life also carries the reserves for the policies written as
well as the underlying investments purchased with the premiums received from
policyholders.
As of December 31, 2005 SVTSs share of the reserves held by GA Life amounted to $118,635
and are included in the consolidated balance sheets as future policy benefits reserve
related to funds withheld reinsurance. The funds withheld reinsurance receivable
presented within the premium and other receivables, net in the consolidated balance
sheets represents the subsidiarys share of the assets supporting the reserves of the
reinsured business and amounted to $118,635 as of December 31, 2005. The coinsurance
funds withheld receivable is supported by certain GA Lifes investments specified in the
coinsurance funds withheld agreement. These investments consist of fixed income
securities (U.S. Treasury securities) and are to be included in a trust on behalf of
SVTS. GA Life must deposit these investments in the trust within 90 days of the effective
date of the agreement.
(17)
Income Taxes
Under Puerto Rico income tax law, the Company is not allowed to file consolidated tax returns
with its subsidiaries.
TSI was exempt through 2002 from Puerto Rico income taxes under a ruling issued by the
Department of the Treasury. On June 18, 2003, the Department of the Treasury notified the
Company that the ruling recognizing TSIs tax exemption was terminated effective December 31,
2002. The termination of the
48
(Continued)
Table of Contents
ruling responds to a new public policy set by the Department of
the Treasury according to which tax exemptions under Section 1101(6) of the Puerto Rico Code
(P.R. Code) will not apply to corporations organized as for-profit, which is TSIs case.
On July 31, 2003, TSM and TSI executed a closing agreement with the Department of the
Treasury. In general, the terms of the closing agreement established the termination of TSIs
tax exemption effective December 31, 2002. Accordingly, since TSIs tax status changed
effective January 1, 2003, TSI is subject to Puerto Rico income taxes as an other-than-life
insurance entity, as defined in the P.R. Code.
The closing agreement also stipulates that TSM will pay taxes (Department of the Treasury tax
assessment) on TSIs accumulated statutory net income, in accordance with the income
recognition methodology applied by the Secretary of the Treasury in the closing agreement and
the ruling mentioned above. This tax ruling established the following methodology for TSM to
determine its tax liability:
TSIs accumulated statutory net income while operating under the tax exemption,
amounting to $132,763, was deemed distributed to TSM.
For tax purposes, TSM recognized the exempt accumulated statutory net income as gross
income. On this amount, TSM recognized an income tax liability amounting to $51,774,
which was determined by applying a tax rate of 39% to the exempt accumulated statutory
net income deemed distributed to TSM. The income tax was recorded by TSM within the
current income tax expense
presented in the consolidated statements of earnings. Of this tax, $37,000 was paid on
July 31, 2003, the date of the closing agreement, and $14,774 on April 15, 2004.
STS is taxed essentially the same as other corporations, with taxable income determined on the
basis of the statutory annual statements filed with the insurance regulatory authorities.
Also, operations are subject to an alternative minimum income tax, which is calculated based
on the formula established by existing tax laws. Any alternative minimum income tax paid may
be used as a credit against the excess, if any, of regular income tax over the alternative
minimum income tax in future years.
TSI, STS, and SVTS are also subject to federal income taxes for foreign source dividend
income. No federal income taxes were recognized for 2005, 2004, and 2003.
SVTS operates as a qualified domestic life insurance company and is subject to the alternative
minimum tax and taxes on its capital gains.
TSM, TCI, and ISI are subject to Puerto Rico income taxes as a regular corporation, as defined
in the P.R. Code, as amended.
49
(Continued)
Table of Contents
The income tax expense differs from the amount computed by applying the Puerto Rico statutory
income tax rate to the income before income taxes as a result of the following:
2005
2004
2003
$
32,197
59,817
91,626
39.0
%
39.0
%
39.0
%
12,557
23,329
35,734
(7,441
)
(5,819
)
(5,516
)
320
(752
)
(327
)
(1,164
)
(84
)
(487
)
(7,014
)
(1,762
)
(2,631
)
(1,826
)
51,774
(430
)
(424
)
(353
)
310
1,172
(5,023
)
1,123
552
195
1,500
(723
)
(153
)
(404
)
(381
)
(947
)
(1,730
)
$
3,764
14,014
65,397
50
(Continued)
Table of Contents
2005
2004
$
4,756
4,258
5,303
3,576
3,253
2,759
1,770
1,447
1,819
2,071
401
423
207
522
133
56
457
419
18,488
15,142
(7,757
)
(5,347
)
(5,090
)
(4,873
)
(1,726
)
(3,331
)
(805
)
(3,330
)
(283
)
(440
)
(230
)
(236
)
(16,337
)
(17,111
)
$
2,151
(1,969
)
(18)
Pension Plan
The Company sponsors a noncontributory defined-benefit pension plan for all of its employees
and for the employees of its subsidiaries who are age 21 or older and have completed one year
of service. Pension benefits begin to vest after five years of vesting service, as defined,
and are based on years of service and final average salary, as defined. The funding policy is
to contribute to the plan as necessary to meet the minimum funding requirements set forth in
the Employee Retirement Income Security Act of 1974, as amended, plus such additional amounts
as the Company may determine to be appropriate from time to
51
(Continued)
Table of Contents
2005
2004
$
71,078
61,336
4,737
4,100
4,145
3,843
(5,106
)
(4,266
)
9,418
6,065
$
84,272
71,078
$
61,467
51,412
2005
2004
$
42,572
32,142
3,214
3,765
8,821
10,931
(5,106
)
(4,266
)
$
49,501
42,572
$
(34,772
)
(28,507
)
550
598
36,722
29,068
$
2,500
1,159
52
(Continued)
Table of Contents
2005
2004
2003
$
4,737
4,100
3,631
4,145
3,843
3,778
(3,467
)
(2,549
)
(2,494
)
48
48
48
2,017
1,706
1,569
4,404
$
7,480
7,148
10,936
2005
2004
2003
5.50
%
5.75
%
6.25
%
8.50
%
8.50
%
8.50
%
Graded; 3.00%
Graded; 3.00%
Graded; 3.00%
to 6.50%
to 6.50%
to 6.50%
2005
2004
2003
5.75
%
6.25
%
6.75
%
8.50
%
8.50
%
8.50
%
Graded; 3.00%
Graded; 3.00%
Graded; 3.00%
to 6.5%
to 6.5%
to 6.5%
53
(Continued)
Table of Contents
(a)
Plan Assets
The Companys weighted average asset allocations at December 31, 2005 and 2004 by asset
category were as follows:
Asset category
2005
2004
59
%
62
%
31
28
8
8
2
2
100
%
100
%
Increasing risk is rewarded with compensating returns over time, and therefore,
prudent risk taking is justifiable for long-term investors.
Risk can be controlled through diversification of assets classes and investment
approaches, as well as diversification of individual securities.
Risk is reduced by time, and over time the relative performance of different
asset classes is reasonably consistent. Over the long-term, equity investments have
provided and should continue to provide superior returns over other security types.
Fixed-income securities can dampen volatility and provide liquidity in periods of
depressed economic activity.
The strategic or long-term allocation of assets among various asset classes is an
important driver of long-term returns.
Relative performance of various asset classes is unpredictable in the short-term
and attempts to shift tactically between asset classes are unlikely to be rewarded.
54
(Continued)
Table of Contents
Ensure assets are available to meet current and future obligations of the
participating programs when due.
Earn a minimum rate of return no less than the actuarial interest rate.
Earn the maximum return that can be realistically achieved in the markets over
the long-term at a specified and controlled level of risk in order to minimize
future contributions.
Invest the assets with the care, skill, and diligence that a prudent person
acting in a like capacity would undertake. The Committee acknowledges that, in the
process, it has the objective of controlling the costs involved with administering
and managing the investments of the National Retirement Trust.
The target asset allocation for the Company is as follows: 53% 67% equity securities;
26% 36% debt securities; 4% 12% real estate; and 0% 4% cash.
(b)
Cash Flows
The Company expects to contribute $6,000 to its pension program in 2006.
The following benefit payments, which reflect expected future service, as appropriate,
are expected to be paid:
(19)
Catastrophe Loss Reserve Trust Fund
In accordance with the Act No. 73 of August 12, 1994, and Chapter 25 of the Insurance Code,
STS is required to establish and maintain a trust fund for the payment of catastrophe losses.
The establishment of this trust fund will increase the financial capacity in order to offer
protection for those insurers exposed to catastrophe losses. This trust may invest its funds
in securities authorized by the Insurance Code, but not in investments whose value may be
affected by hazards covered by the catastrophic insurance losses. The interest earned on these
investments and any realized gain (loss) on investment transactions becomes part of the
reserve for catastrophic insurance losses and income (expense) of the Company. The assets in
this fund, which are reported as other assets in the accompanying consolidated balance sheets,
will be used solely and exclusively to pay catastrophe losses covered under policies written
in Puerto Rico.
55
(Continued)
Table of Contents
2005
2004
$
24,123
22,418
1,025
1,042
25,148
23,460
721
663
$
25,869
24,123
2005
2004
$
18,297
16,598
5,037
5,035
1,500
1,500
242
219
72
108
$
25,148
23,460
56
(Continued)
Table of Contents
Amortized
Estimated
cost
fair value
$
12,296
12,128
7,569
7,353
4,969
4,728
$
24,834
24,209
(20)
Commitments
The Company leases its regional offices, certain equipment, and warehouse facilities under
noncancelable operating leases. Minimum annual rental commitments at December 31, 2005 under
existing agreements are summarized as follows:
$
1,600
1,370
771
415
371
190
$
4,717
(21)
Contingencies
(a)
Legal Proceedings
(i)
At December 31, 2005, the Company is defendant in various lawsuits
arising in the ordinary course of business. In the opinion of management, with the
advice of its legal counsel, the ultimate disposition of these matters will not have
a material adverse effect on the consolidated financial position and results of
operations of the Company.
(ii)
The Company and others are defendants in a class action complaint
alleging violations under the Racketeer Influenced and Corrupt Organizations Act.
The suit, among other allegations, alleges a scheme to defraud the plaintiffs by
acquiring control of TSI through illegally capitalizing TSI and later converting it
into a for-profit organization and depriving the stockholders of TSI of their
ownership rights. The plaintiffs base their later allegations on the supposed
decisions of TSIs board of directors and stockholders, allegedly made in 1979, to
57
(Continued)
Table of Contents
(iii)
TSM, TSI, and others are defendants in a complaint where the plaintiffs
allege that the defendants, among other things, violated provisions of the Puerto
Rico Insurance Code, anti-monopolistic practices and unfair business practices.
After a preliminary review of the complaint, it appears that many of the allegations
brought by the plaintiffs have been resolved in favor of TSM and TSI in previous
cases brought by the same plaintiffs in the U.S. District Court for the District of
Puerto Rico and by most of the plaintiffs in the local courts. The defendants,
including TSM and TSI answered the complaint, filed a counter-claim and filed
several motions to dismiss this claim. On May 9, 2005, the plaintiffs filed the
amended complaint and defendants are preparing the corresponding motions to dismiss
this amended complaint. The plaintiffs amended the complaint to allege similar
causes of action dismissed
by the U.S. District Court for the District of Puerto Rico in the case described in
bullet (ii) above. Defendants moved to dismiss the amended complaint. Plaintiffs
have notified their opposition to some of the defendants motion to dismiss, and
the defendants filed the corresponding replies. On January 25, 2006, the Court held
a hearing to argue the disposition of motions. In the opinion of management, with
the advice of its legal counsel, the ultimate disposition of these matters will not
have a material adverse effect on the consolidated financial position and results
of operations of the Company.
(iv)
On May 22, 2003, a class action suit was filed by Kenneth A. Thomas, MD
and Michael Kutell, MD, on behalf of themselves and all other similarly situated and
the Connecticut State Medical Society against the BCBSA and multiple other insurance
companies including TSI. The individual plaintiffs bring this action on behalf of
themselves and a class of similarly situated physicians seeking redress for alleged
illegal acts of the defendants, which they allege have resulted in a loss of their
property and a detriment to their business, and for declaratory and injunctive
relief to end those practices and prevent further losses. Plaintiffs alleged that
the defendants, on their own and as part of a common scheme, systematically deny,
delay, and diminish the payments due to doctors so that they are not paid in a
timely manner for the
58
(Continued)
Table of Contents
covered, medically necessary services they render. The class
action complaint alleges that the healthcare plans are the agents of Blue Cross and
Blue Shield licensed entities, and as such have committed the acts alleged above and
acted within the scope of their agency, with the consent, permission, authorization,
and knowledge of the others, and in furtherance of both their interest and the
interests of other defendants. Management believes that TSI was brought to this
litigation for the sole reason of being associated with BCBSA. However, on June 18,
2004, the plaintiffs moved to amend the complaint to include the Colegio de Médicos
Cirujanos de Puerto Rico (a compulsory association grouping all physicians in Puerto
Rico), Marissel Velázquez, MD, President of the Colegio de Médicos y Cirujanos de
Puerto Rico, and Andrés Meléndez, MD, as plaintiffs against TSI. Later Marissel
Velázquez, MD voluntarily dismissed her complaint against TSI. TSI, along with the
other defendants, moved to dismiss the complaint under multiple grounds, including
but not limited to arbitration and applicability of the McCarran Ferguson Act. The
Court issued a 90-day stay to allow the parties to discuss their differences and
come to an amicable agreement. The stay expired on March 7, 2006. Upon the
expiration of the stay, both plaintiffs and defendants agreed to request the Court
to extend the stay until April 21, 2006. In the opinion of management, with the
advice of its legal counsel, the ultimate disposition of these matters will not have
a material adverse effect on the consolidated financial position and results of
operations of the Company.
(v)
On December 8, 2003, a putative class action was filed by Jeffrey
Solomon, MD, and Orlando Armstrong, MD, on behalf of themselves and all other
similarly situated and the American Podiatric Medical Association, Florida
Chiropractic Association, California Podiatric Medical Association, Florida
Podiatric Medical Association, Texas Podiatric Medical Association, and Independent
Chiropractic Physicians, against the BCBSA and multiple other insurance companies,
including TSI, all members of the BCBSA. The individual plaintiffs bring this action
on behalf of themselves and a class of similarly situated physicians seeking redress
for alleged illegal acts of the defendants, which are alleged to have resulted in a
loss of Plaintiffs
property and a detriment to their business, and for declaratory and injunctive
relief to end those practices and prevent further losses. Plaintiffs alleged that
the defendants, on their own and as part of a common scheme, systematically deny,
delay and diminish the payment due to the doctors so that they are not paid in a
timely manner for the covered, medically necessary services they render. The class
action complaint alleges that the healthcare plans are the agents of BCBSA licensed
entities, and as such have committed the acts alleged above and acted within the
scope of their agency, with the consent, permission, authorization, and knowledge
of the others, and in furtherance of both their interest and the interests of other
defendants. On June 25, 2004, plaintiffs amended the complaint but the allegations
against TSI did not vary. Management believes that TSI was made a party to this
litigation for the sole reason that TSI is associated with the BCBSA. TSI, along
with the other defendants, moved to dismiss the complaint under multiple grounds,
including but not limited to arbitration and applicability of the McCarran Ferguson
Act. The Court issued a 90-day stay to allow the parties to discuss their
differences and come to an amicable solution. The stay expired on March 7, 2006.
Although the parties are still in the process of discussing their differences, they
have not moved the Court to extend the stay. The defendants suggested that
plaintiffs join in a request to extend the stay, but the plaintiffs have not
reacted to the defendants invitation. In the
59
(Continued)
Table of Contents
(b)
Guarantee Associations
Pursuant to the Insurance Code, STS is a member of Sindicato de Aseguradores para la
Suscripción Conjunta de Seguros de Responsabilidad Profesional Médico-Hospitalaria
(SIMED) and of the Sindicato de Aseguradores de Responsabilidad Profesional para Médicos.
Both syndicates were organized for the purpose of underwriting medical-hospital
professional liability insurance. As a member, the subsidiary shares risks with other
member companies and, accordingly, is contingently liable in the event that the
above-mentioned syndicates cannot meet their obligations. During the year 2005 STS
released an estimated assessment recorded in prior years amounting to $416 based on the
audited financial statements received from SIMED reflecting an improved financial
condition. During 2005, and 2004, no assessments or payments were made for this
contingency.
Additionally, pursuant to Article 12 of Rule LXIX of the Insurance Code, STS is a member
of the Compulsory Vehicle Liability Insurance Joint Underwriting Association (the
Association). The Association was organized during 1997 to underwrite insurance coverage
of motor vehicle property damage liability risks effective January 1, 1998. As a
participant, STS shares the risk, proportionately with other members, based on a formula
established by the Insurance Code. During the three-year period ended December 31, 2004,
the Association distributed good experience refunds. STS received refunds amounting to
$918, $840, and $638 in 2005, 2004, and 2003, respectively.
STS is a member of the Asociación de Garantía de Seguros de Todas Clases, excepto Vida,
Incapacidad y Salud and TSI and SVTS are members of the Asociación de Garantía de Seguros
de Vida, Incapacidad y Salud. As members, they are required to provide funds for the
payment of
claims and unearned premiums reimbursements for policies issued by insurance companies
declared insolvent. During 2005, 2004, and 2003, STS paid assessments of $965, $1,121,
and $500, respectively. Moreover, no assessments were attributable to TSI and SVTS during
2005, 2004, and 2003.
(22)
Net Income Available to Stockholders and Basic Net Income per Share
The Company presents only basic earnings per share, which is comprised of the net income that
could be available to common stockholders divided by the weighted average number of common shares outstanding for the period.
60
(Continued)
Table of Contents
2005
2004
2003
$
28,433
45,803
26,229
8,904
8,919
9,180
$
3,193
5,135
2,857
(23)
Subsequent Events
On January 13, 2006, the board of directors (the Board) declared a cash dividend of $6,226 to
be distributed pro rata among all of the Companys issued and outstanding common shares,
excluding those shares issued to the representatives of the community that are members of the
Board (the qualifying shares). All stockholders of record as of the close of business on
January 16, 2006, except those who only hold qualifying shares, received a dividend per share
of $700 for each share held on that date.
(24)
Business Combinations
Effective January 31, 2006, the Company acquired 100% of the common stock of GA Life. As a
result of this acquisition, the Company is expected to be one of the leading providers of life
insurance policies in Puerto Rico. The acquisition will be accounted by the Company in
accordance with the provisions of SFAS No. 141,
Business Combinations
. The results of
operations of GA Life are not reflected in the accompanying consolidated financial statements
since the effective date of the transaction is not until 2006. The aggregate purchase price of
the acquired entity amounted to approximately $38,196; of this amount $37,500 were paid in
cash on January 31, 2006 and $696 are the estimated direct costs related to the acquisition.
The Company is in the process of obtaining third-party valuations of certain intangible
assets; thus, as of this date it is not possible to determine the allocation of the purchase
price to the net assets acquired.
(25)
Statutory Accounting
TSI, SVTS, and STS (collectively known as the regulated subsidiaries) are regulated by the
Commissioner of Insurance. The regulated subsidiaries are required to prepare financial
statements using accounting practices prescribed or permitted by the Commissioner of
Insurance, which differ from U.S. GAAP.
The principal differences resulting between the financial statements of the regulated
subsidiaries under statutory accounting practices with U.S. GAAP are as follows:
The accounting basis of investments in debt and equity securities are based upon the
rules promulgated by NAIC Statutory Accounting Principles (SAP).
61
(Continued)
Table of Contents
Certain assets (primarily prepaid expenses, furniture and equipment, and premiums
balances not collected within 90 days) are classified as nonadmitted and are excluded
from the balance sheets by a charge to unassigned capital and surplus.
Certain notes payable are classified as surplus notes under statutory accounting
practices.
Policy acquisitions costs (mainly commissions) are not deferred over the periods in
which the premiums are earned but charged to operations as incurred.
2005 (Unaudited)
TSI
STS
SVTS
$
506,386
246,493
199,728
168,542
42,618
16,454
195,542
68,404
19,014
62
(Continued)
Table of Contents
2004
TSI
STS
SVTS
$
494,199
225,684
71,551
164,698
36,831
20,045
191,239
69,455
21,245
TSI
STS
SVTS
$
17,383
10,098
(58,046
)
31,045
9,589
607
41,321
6,207
3,990
63
(Continued)
Table of Contents
(26)
Quarterly Financial Information (Unaudited)
2005
March 31
June 30
September 30
December 31
Total
$
333,389
339,618
345,728
361,469
1,380,204
51,915
52,439
53,424
53,127
210,905
(48,540
)
(49,302
)
(50,190
)
(48,428
)
(196,460
)
336,764
342,755
348,962
366,168
1,394,649
7,064
7,217
7,158
7,590
29,029
3,314
1,363
1,857
627
7,161
(5,793
)
(634
)
905
813
(4,709
)
632
(142
)
1,576
1,666
3,732
341,981
350,559
360,458
376,864
1,429,862
302,923
297,901
299,577
307,966
1,208,367
43,766
45,453
44,568
47,916
181,703
1,788
1,856
1,880
2,071
7,595
348,477
345,210
346,025
357,953
1,397,665
(6,496
)
5,349
14,433
18,911
32,197
1,221
758
802
1,143
3,924
(2,510
)
183
1,758
409
(160
)
(1,289
)
941
2,560
1,552
3,764
$
(5,207
)
4,408
11,873
17,359
28,433
$
(585
)
495
1,333
1,950
3,193
64
(Continued)
Table of Contents
2004
March 31
June 30
September 30
December 31
Total
$
318,646
322,896
325,926
328,955
1,296,423
43,038
46,045
46,044
46,575
181,702
(40,582
)
(42,485
)
(42,925
)
(43,932
)
(169,924
)
321,102
326,456
329,045
331,598
1,308,201
6,582
6,393
6,516
7,008
26,499
1,383
1,365
4,237
3,983
10,968
1,819
(3,252
)
(435
)
4,910
3,042
566
1,120
728
946
3,360
331,452
332,082
340,091
348,445
1,352,070
275,748
286,246
283,946
269,853
1,115,793
39,838
42,635
40,416
48,990
171,879
901
931
1,018
1,731
4,581
316,487
329,812
325,380
320,574
1,292,253
14,965
2,270
14,711
27,871
59,817
3,298
1,248
2,756
6,983
14,285
511
(457
)
(139
)
(186
)
(271
)
3,809
791
2,617
6,797
14,014
$
11,156
1,479
12,094
21,074
45,803
$
1,239
166
1,361
2,371
5,137
65
(Continued)
Table of Contents
(27)
Reconciliation of Net Income to Net Cash Provided by Operating Activities
A reconciliation of net income to net cash provided by operating activities follows:
2005
2004
2003
$
28,433
45,803
26,229
5,230
5,343
5,709
408
1,035
1,866
(617
)
(464
)
(1,188
)
1,067
2,158
(4,779
)
(160
)
(271
)
(5,396
)
(7,161
)
(10,968
)
(8,365
)
4,709
(3,042
)
(14,893
)
102,667
50,330
77,582
36,156
26,523
28,924
(30,502
)
(54,550
)
(96,237
)
(25,785
)
(38,700
)
(38,956
)
(1
)
(16
)
(58
)
(11,988
)
(10,956
)
4,809
6
18
(218
)
1,680
(11,052
)
(9,062
)
(118,635
)
(62,856
)
(2,041
)
(2,901
)
(16,110
)
(5,138
)
(3,188
)
2,412
16,267
(6,613
)
15,900
14,875
9,139
(74
)
263
812
118,635
1,231
1,003
365
11,120
5,879
7,743
(5,435
)
2,320
405
588
4,616
6,914
(1,827
)
(30,395
)
31,506
$
49,091
8,840
10,149
66
(Continued)
Table of Contents
2005
2004
2003
$
(18,832
)
1,101
(6,022
)
13,054
1,594
457
281
103
(2,788
)
(3
)
2,292
67
(Continued)
Table of Contents
(Parent Company Only)
Table of Contents
Triple-S Management Corporation:
San Juan, Puerto Rico
Society of Certified Public Accountants
was affixed to the record copy of this report.
Table of Contents
(Parent Company Only)
2005
2004
$
50
4,031
1,436
766
15
102
1,451
868
10,004
7,205
92
130
316
404
2,500
1,159
96
96
621
15
15,130
13,908
83,000
26,000
1,000
1,000
2,142
788
312
515
299,421
293,203
24,760
25,577
1,275
$
427,040
360,991
$
1,640
3,140
10,509
8,136
6,873
5,440
19,022
16,716
365
252
98,950
42,590
118,337
59,558
356
356
150,408
150,408
162,964
134,531
(5,025
)
16,138
308,703
301,433
$
427,040
360,991
* Eliminated on consolidation.
Table of Contents
(Parent Company Only)
2005
2004
2003
$
6,724
6,290
6,082
(5,271
)
(4,787
)
(5,570
)
1,453
1,503
512
27,604
45,451
77,736
(336
)
(863
)
(982
)
650
27,268
44,588
77,404
28,721
46,091
77,916
208
306
51,834
80
(18
)
(147
)
288
288
51,687
$
28,433
45,803
26,229
* Eliminated on consolidation.
Table of Contents
(Parent Company Only)
Accumulated
Additional
other
Common
paid-in
Retained
comprehensive
stock
capital
earnings
income (loss)
Total
$
373
150,406
62,499
18,386
231,664
(12
)
1
(11
)
26,229
26,229
(6,022
)
(6,022
)
2,292
2,292
103
103
22,602
361
150,407
88,728
14,759
254,255
(5
)
1
(4
)
45,803
45,803
1,101
1,101
(3
)
(3
)
281
281
47,182
356
150,408
134,531
16,138
301,433
28,433
28,433
(18,832
)
(18,832
)
(2,788
)
(2,788
)
457
457
7,270
$
356
150,408
162,964
(5,025
)
308,703
Table of Contents
(Parent Company Only)
2005
2004
2003
$
28,433
45,803
26,229
(27,604
)
(45,451
)
(77,736
)
1,090
1,118
1,110
(650
)
(1
)
(1
)
(25
)
(44
)
(88
)
(138
)
80
(18
)
(147
)
(583
)
(699
)
207
(1,354
)
(729
)
4,759
(2,553
)
(1,245
)
89
3,948
5,834
(480
)
(14,339
)
13,876
1,432
(9,771
)
(32,970
)
(3,000
)
(1,430
)
(8,892
)
1,280
6,689
(57,000
)
(273
)
(39
)
(11
)
(60,273
)
(189
)
(2,214
)
15,000
37,800
(5,140
)
(2,645
)
(1,640
)
60,000
(4
)
(11
)
54,860
12,351
36,149
(3,981
)
2,391
965
4,031
1,640
675
$
50
4,031
1,640
$
170
14,774
37,958
2,093
1,951
1,867
(18,667
)
1,130
(5,532
)
(165
)
(29
)
(490
)
457
281
103
(2,788
)
(3
)
2,292
*
Eliminated on consolidation.
Table of Contents
(Parent Company Only)
2005
2004
$
6,531
6,531
27,765
27,492
34,296
34,023
(9,536
)
(8,446
)
$
24,760
25,577
Table of Contents
(Parent Company Only)
2005
2004
$
704,252
700,001
257,531
124,732
163,343
76,710
$
1,125,126
901,443
$
297,563
279,325
118,635
95,703
84,583
41,738
34,071
272,066
210,261
$
825,705
608,240
$
299,421
293,203
Table of Contents
(Parent Company Only)
2005
2004
$
11,500
15,000
60,000
29,090
30,730
100,590
45,730
(1,640
)
(3,140
)
$
98,950
42,590
$
1,640
13,140
1,640
1,640
1,640
80,890
$
100,590
Table of Contents
(Parent Company Only)
Maximum
principal
outstanding
Date
balance
$
12,000
Table of Contents
(Parent Company Only)
TSIs accumulated statutory net income while operating under the tax exemption,
amounting to $132,763, was deemed distributed to TSM.
For tax purposes, TSM recognized the exempt accumulated statutory net income as gross
income. On this amount, TSM recognized an income tax liability amounting to $51,774,
which was determined by applying a tax rate of 39% to the exempt accumulated statutory
net income deemed distributed to TSM. The income tax was recorded by TSM within the
current income tax expense presented in the consolidated statements of earnings. Of this
tax, $37,000 were paid on July 31, 2003, the date of the closing agreement, and $14,774
on April 15, 2004.
2005
2004
2003
$
11,201
17,975
30,387
(10,765
)
(17,726
)
(30,317
)
(68
)
97
50
51,774
(80
)
(58
)
(207
)
$
288
288
51,687
Table of Contents
(Parent Company Only)
2005
2004
$
32
42
136
92
208
68
16
11
239
206
401
423
56
58
21
1,090
919
(226
)
(236
)
(462
)
$
628
919
2005
2004
2003
$
6,588
6,083
5,772
1,353
734
658
Table of Contents
(Parent Company Only)
Table of Contents
Schedule III Supplementary Insurance Information
For the years ended December 31, 2005, 2004 and 2003
Deferred
Other
Amortization of
Policy
Policy Claims
Net
Deferred Policy
Other
Net
Acquisition
Claim
Unearned
and Benefits
Premium
Investment
Claims
Acquisition
Operating
Premiums
Segment
Costs
Liabilities
Premiums
Payable
Revenue
Income
Incurred
Costs
Expenses
Written
$
$
108,518
$
8,829
$
$
784,187
$
13,904
$
677,870
$
$
103,562
$
784,187
70,460
510,839
2,945
478,008
36,432
510,839
19,891
96,107
86,693
86,767
8,706
43,587
23,137
16,505
91,883
61,677
22,478
181
118,635
17,130
3,018
8,902
264
7,937
17,130
(4,274
)
456
(6,134
)
$
81,568
$
297,563
$
95,703
$
118,635
$
1,394,649
$
29,029
$
1,208,367
$
23,401
$
158,302
$
1,404,039
$
$
101,773
$
6,249
$
$
724,734
$
12,590
$
620,750
$
$
94,930
$
724,734
67,137
484,742
3,109
437,835
35,777
484,742
17,825
89,627
77,853
86,228
7,668
45,977
22,388
17,794
89,659
887
20,788
481
16,442
2,778
11,231
66
7,281
16,442
(3,945
)
354
(6,357
)
$
18,712
$
279,325
$
84,583
$
$
1,308,201
$
26,499
$
1,115,793
$
22,454
$
149,425
$
1,315,577
$
$
93,273
$
5,833
$
$
702,853
$
10,734
$
584,448
$
$
92,264
$
702,853
66,243
477,614
4,476
428,045
34,637
477,614
16,179
72,431
72,785
78,334
6,824
43,390
19,461
17,893
84,357
492
15,973
86
17,403
2,345
9,467
29
6,007
17,403
(3,488
)
300
(5,142
)
$
16,671
$
247,920
$
78,704
$
$
1,272,716
$
24,679
$
1,065,350
$
19,490
$
145,659
$
1,282,227
Table of Contents
Schedule IV Reinsurance
For the years ended December 31, 2005, 2004 and 2003
Percentage
Ceded to
Assumed
of Amount
Gross
Other
from Other
Net
Assumed
Amount
Companies (1)
Companies
Amount
to Net
$
4,443,620
1,887,180
2,556,440
0.0
%
$
8,768
2,824
400
6,344
6.3
%
1,312,106
6,294
1,305,812
0.0
%
151,127
59,244
91,883
0.0
%
$
1,472,001
68,362
400
1,404,039
0.0
%
$
4,575,470
2,443,567
2,131,903
0.0
%
$
23,709
7,267
16,442
0.0
%
1,210,584
1,108
1,209,476
0.0
%
141,874
52,215
89,659
0.0
%
$
1,376,167
60,590
1,315,577
0.0
%
$
6,027,145
2,865,885
3,161,260
0.0
%
$
24,703
7,300
17,403
0.0
%
1,180,468
1,180,468
0.0
%
128,127
43,771
84,356
0.0
%
$
1,333,298
51,071
1,282,227
0.0
%
(1)
Premiums ceded on the life insurance business are net of commission income on reinsurance amounting
to $541, $699 and $516 for the years ended December 31, 2005, 2004 and 2003.
Table of Contents
Schedule V Valuation and Qualifying Accounts
For the years ended December 31, 2005, 2004 and 2003
Additions
Balance at
Charged to
Charged to
Balance at
Beginning of
Costs and
Other Accounts
Deductions -
End of
Period
Expenses
- Describe (1)
Describe (2)
Period
$
11,173
3,829
(2,762
)
12,240
$
9,015
5,166
(3,008
)
11,173
$
13,794
3,068
290
(8,137
)
9,015
(1)
Represents the recovery of accounts previously written-off.
(2)
Deductions represent the write-off of accounts deemed uncollectible and other deductions.
EXHIBIT 10.14
REINSURANCE AGREEMENT
EFFECTIVE DATE: December 22, 2005
BETWEEN
GREAT AMERICAN LIFE ASSURANCE COMPANY
OF PUERTO RICO
1052 Munoz Rivera Avenue
Rio Piedras, Puerto Rico 00936-3786
(Referred to in this Agreement as the Company)
AND
SEGUROS DE VIDA TRIPLE-S, INC.
1441 F. D. Roosevelt Avenue
San Juan, Puerto Rico 00936-3628
(Referred to in this Agreement as the Reinsurer)
COINSURANCE FUNDS WITHHELD
DECEMBER 15, 2005
TABLE OF CONTENTS Article I Preamble Article II Automatic Reinsurance Article III Liability Article IV Reinsured Risk Amount Article V Premium Accounting Article VI Coinsurance Funds Withheld Article VII Reductions, Terminations and Changes Article VIII Warranties and Covenants Article IX Claims Article X Recapture Article XI General Provisions Article XII Insolvency Article XIII Reinsurer's Right of Notice of Unusual Practices Article XIV Arbitration Article XV Confidentiality Article XVI Duration of Agreement Article XVII Eligible Policies and Execution 2 |
Exhibit A Retention Limits of the Company Exhibit B Plans Covered Exhibit C Automatic Binding Limits Exhibit D-1 Procedures For Reporting Exhibit D-2 Request For Financial Reporting Information Exhibit E Reinsurance Premium Rates, Administrative Expense Allowances and Commission Allowances Exhibit F Assets To Be Held in Trust Exhibit G Trust Agreement Exhibit H Accounting and Cash Transfer Provisions |
ARTICLE I
PREAMBLE
1) Parties to the Agreement. This is a Coinsurance Funds Withheld Agreement for indemnity reinsurance (the "Agreement") solely between Seguros de Vida Triple-S, Inc., San Juan, Puerto Rico (the "Reinsurer"), and Great American Life Assurance Company of Puerto Rico a/k/a Great American PR, Rio Piedras, Puerto Rico (the "Company"), collectively referred to as the "parties".
The acceptance of risks under this Agreement will create no right or legal relationship between the Reinsurer and the insured, owner or beneficiary of any insurance policy or other contract of the Company.
The Agreement will be binding upon the Company and the Reinsurer and their respective successors and assigns.
2) Compliance. This Agreement applies only to the issuance of insurance by the Company in a jurisdiction in which it is properly licensed.
The Company represents that it is in compliance with all laws applicable to the business reinsured under this Agreement. In the event that the Company is found to be in non-compliance with any law material to this Agreement, the Agreement will remain in effect and the Company will indemnify the Reinsurer for any loss (including any costs and expenses relating to such loss) the Reinsurer suffers as a result of the non-compliance, and will seek to remedy, at the Company's sole expense, the non-compliance immediately upon discovery thereof.
3) Construction. This Agreement will be construed in accordance with the laws under the Commonwealth of Puerto Rico.
4) Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to the business reinsured hereunder. There are no understandings between the parties other than as expressed in this Agreement. Any change or modification to this Agreement will be null and void unless made by amendment to this Agreement and signed by both parties.
5) Severability. If any provision of this Agreement is determined to be invalid or unenforceable, such determination will not impair or affect the validity or the enforceability of the remaining provisions of this Agreement.
6) Assignment. Neither party may assign, transfer, sell, convey or otherwise dispose of any of its rights, duties or obligations under this Agreement without the prior written consent of the other party, which consent shall not be unreasonably withheld; provided, however, that the parties acknowledge and agree that the Reinsurer may retrocede any or all of its reinsured net amount at risk hereunder.
...END OF ARTICLE I
ARTICLE II
AUTOMATIC REINSURANCE
1) General Conditions. On and after the effective date of this Agreement, the Company will automatically cede, in respect of all new business written as of and after the effective date, to the Reinsurer that portion (69%) of the life insurance, annuities, accident and supplemental health, supplementary benefits, and riders referred to in Exhibit B, net of Third Party = Reinsurers.
The Reinsurer will automatically accept its share of the above-referenced policies up to the limits shown in Exhibit C and will pay its share of claims made against or under such policies (as of and after the effective date), provided that:
a. the Company keeps its full retention, as specified in Exhibit A, or otherwise holds its full retention on a life under previously issued inforce policies (and does not transfer, assign, convey, reinsure or otherwise dispose of such retention without the Reinsurer's prior written consent);
b. The insured is a resident of a territory listed in Exhibit C.
...END OF ARTICLE II
ARTICLE III
LIABILITY
1) The Reinsurer's liability will commence on December 22, 2005 and will continue in accordance with the terms and conditions of this Agreement, and will end at the same time as that of the Company as specified in the terms of each of the policies subject to reinsurance by the Reinsurer hereunder. Payment by the Company to the Reinsurer of reinsurance premium is a condition precedent to the Reinsurer's liability hereunder.
...END OF ARTICLE III
ARTICLE IV
REINSURED RISK AMOUNT
1) Coinsurance plans. Reinsurance premiums are equal to the gross premiums collected on the amounts retained by the Company on the business reinsured multiplied by the reinsurer's coinsurance percentage as defined in Exhibit C.
2) Waiver of Premium and Payor Benefits (as applicable) shall be on a coinsured basis in accordance with the benefit form issued by the Company. The Reinsurer's amount at risk shall be in proportion to the net amount at risk on the underlying policy.
3) Accidental Death Benefit (as applicable) shall be on a coinsurance basis. The Reinsurer's amount at risk shall not exceed the amount in Exhibit C.
...END OF ARTICLE IV
ARTICLE V
PREMIUM ACCOUNTING
1) Premiums. Reinsurance premium rates for life insurance, accident and supplemental health insurance and other benefits reinsured under this Agreement are gross premiums charged by the Company multiplied by the reinsurer's coinsurance percentage shown in Exhibit C.
2) Payment of Premiums and Reporting. Reinsurance premiums are payable
quarterly and in arrears. Each quarter the Company will self-administer
the calculation and payment of reinsurance premium due and, within thirty
(30) days after the end of the quarter, will send the Reinsurer a report
that contains the information shown in Exhibit D, showing reinsurance
premiums due for that quarter. If an amount is due the Reinsurer, the
Company will remit that amount in cash together with the statement. The
Company will furnish to the Reinsurer upon the Reinsurer's request all
such supporting documentation underlying the quarterly premium
computations as the Reinsurer may request, and shall confer with the
Reinsurer, upon the request of the Reinsurer, to address any uncertainties
in such quarterly premium computations. See Exhibit H, "Accounting and
Cash Transfer Provisions", the provisions of which are incorporated
herein.
3) Failure to Pay Premiums. The payment of reinsurance premiums, as and when due under the terms hereof, is a condition precedent to the liability of the Reinsurer for reinsurance covered by this Agreement. In the event that reinsurance premiums are not paid within thirty (30) days of the due date, the Reinsurer will have the right to terminate the reinsurance under all policies having reinsurance premiums in arrears. If the Reinsurer elects to exercise its right of termination, it will give the Company thirty (30) days written notice of termination (the date of the giving of such notice, the "Notice Date"), and termination will be effective on and as of the date which is 30 days following the Notice Date.
If all reinsurance premiums in arrears, including any that become in arrears during the thirty- day notice period, are not paid before the expiration of the notice period, the Reinsurer will be relieved of all liability under those policies as of the last date to which premiums have been paid for each less any cash values or recapture reserve amounts due. Reinsurance on policies on which reinsurance premiums subsequently fall due will automatically terminate as of the last date to which premiums have been paid for each policy, unless reinsurance premiums on those policies are paid on or before their Remittance Dates. Reinsurance Premium in arrears shall accrue interest at a rate equal to 6% per annum.
Terminated reinsurance may be reinstated, subject to approval by the Reinsurer, within sixty (60) days of the date of termination, and upon payment of all reinsurance premiums in arrears including any interest accrued thereon. The Reinsurer will have no liability for any claims incurred between the date of termination and the date of the reinstatement of the reinsurance. The right to terminate reinsurance will not prejudice the Reinsurer's right to collect premiums for the period during which reinsurance was in force prior to the expiration of the thirty (30) day notice.
The Company will not force termination under the provisions of this Article solely to avoid the provisions regarding recapture in Article X, or to transfer the reinsured policies to another reinsurer.
4) Although the Reinsurer anticipates that the premium rates and allowances in Exhibit E will apply indefinitely, these rates and allowances are guaranteed only to the extent that the Company guarantees its rates to its policyholders, and only so long as the Company does not modify either the premiums or cost-of-insurance charges of the underlying policies. To the extent the Company modifies premium or cost-of-insurance charges on the underlying policies, or otherwise adjusts the rates the Company charges to its policyholders, the Reinsurer may modify the reinsurance premium rates and allowances in Exhibit E, in which case the Company may recapture such underlying policies based upon terms mutually acceptable to the Company and the Reinsurer.
5) Electronic Data Transmission. If the Company chooses to report its reinsurance transactions via electronic media, the Company shall consult with the Reinsurer to determine the appropriate reporting format. Should the Company subsequently desire to make changes in the data format or the code structure, the Company shall communicate such changes to the Reinsurer in writing prior to the use of such changes in reports to the Reinsurer and shall describe in reasonable detail such proposed changes. Changes in Plan codes and Smoker codes shall be described with particularity.
6) Unearned Premium. The Reinsurer will follow the practices of the Company with regard to refund of premium upon death, surrender, or other termination.
...END OF ARTICLE V
ARTICLE VI
COINSURANCE FUNDS WITHHELD
The reinsurance hereunder shall be on a quota share Coinsurance Funds Withheld basis. The quota share reinsured shall be 69%. Funds withheld will be defined at inception as equal to the reinsurance share of the initial reserves (69%) . The Reinsurer's funds withheld asset will be supported by the Company's specific assets listed in Exhibit F and the Company has agreed to hold these assets (listed therein) in trust on behalf of the Reinsurer with those assets being deposited in such trust within ninety (90) days of the Effective Date. . The value of the assets held in trust shall, in the aggregate, approximate as closely as possible the amount of the Reinsurer's Funds Withheld; where the value of the assets is less than the amount of Funds Withheld (and it is not contemplated by the parties that the difference would be a material difference) the Company shall deposit cash into the trust so that the value of the assets in trust taken together with the cash equals the amount of the Reinsurer's Funds Withheld. The assets will be held in trust, and no other assets will be added to the trust except that, in the event that one or more assets held in trust matures during the term of the trust, the Company, subject to the prior agreement of the Reinsurer, will substitute such asset or assets for another asset or assets of equal value to the asset or assets (as the case may be) which have matured, and which is or are otherwise acceptable to the Reinsurer. The interest payable to the Reinsurer on the funds withheld will be as set for in Exhibit H.
As used herein, the term "initial reserves" means the difference between (A) an amount equal to the sum of amounts shown on liability (page 3) lines 1 through 8 and 9.1, 9.2, and 9.3 of the Company's Annual Statement as filed with the Office of the Commissioner of Insurance of the Commonwealth of Puerto Rico (the "Annual Statement"), and (B) the amount equal to the sum of the amounts shown as admitted assets on asset lines 12.1 and 12.2 of the Annual Statement; provided it is understood and agreed that for purposes of computation contemplated hereunder the Company's initial reserves as of December 31, 2005 shall be deemed to be the Company's initial reserves as of the effective date of the Agreement.
The Reinsurer shall establish, on its statutory financial statements for each reporting period, reserves and other financial items on a basis consistent with the reinsurance share of the initial reserves.
...END OF ARTICLE VI
ARTICLE VII
REDUCTIONS, TERMINATIONS AND CHANGES
Whenever a change is made in the status, plan, amount or other material feature of a policy reinsured under this Agreement, the Reinsurer will, upon receipt of notification of the change, provide adjusted reinsurance coverage in accordance with the provisions of this Agreement. The Company will notify the Reinsurer of any such change with the next statement following the month in which the change was made.
1) Reductions and Terminations
In the event of the reduction, lapse, or termination of a policy or policies reinsured under this Agreement or any other agreement, the Company will reduce or terminate reinsurance on that life. The reinsured amount on the life with all reinsurers will be reduced, effective on the same date, by the amount required such that the Company maintains its retention as defined under this Agreement.
The Reinsurer will refund any unearned reinsurance premiums net of allowances. However, the reinsured portion of any policy fee (if applicable - See Exhibit E) will be deemed earned for a policy year if the policy is reinsured during any portion of that policy year.
2) Increases
For policies reinsured under this Agreement, reinsurance of increases in amounts resulting from contractual policy provisions will be accepted only up to the Automatic Binding Limits shown in Exhibit C.
3) Reinstatement. If a policy reinsured on an automatic basis is reinstated in accordance with its terms and in accordance with Company rules and procedures (a copy of which shall have been provided to the Reinsurer prior to, or at, the date hereof), the Reinsurer will, upon notification of reinstatement, reinstate the reinsurance coverage. The Company will promptly furnish the Reinsurer with a copy of any amendment made from time to time to the Company's rules and procedures.
Upon reinstatement of the reinsurance coverage, the Company will pay the contractual reinsurance premiums plus accrued interest for the period and at the interest rate stated in Article V, paragraph 3.
4) Nonforfeiture Benefits
a. Extended Term
If the original policy lapses and extended term insurance is elected under the terms of the policy, reinsurance will continue on the same basis (subject to other provisions of this Agreement) as under the original policy until the expiry of the extended term period.
b. Reduced Paid-up
The amount reinsured and the amount retained will be reduced proportionately.
5) Cash Surrenders. The Reinsurer will reimburse the Company for its proportionate share of the cash surrender amount payable by the Company upon surrender of the policy less any outstanding policy loans.
6) Policy Loans. The Reinsurer shall participate in policy loans and other forms of indebtedness on policies reinsured under this Agreement. See Exhibit H, the relevant terms of which are incorporated herein.
...END OF ARTICLE VII
ARTICLE VIII
WARRANTIES AND COVENANTS
1) The Company warrants and covenants that no policy reinsured under this Agreement may be converted, exchanged or replaced by another policy or policy form on a non-contractual basis within the Company. Unless mutually agreed otherwise, policies that are not reinsured with the Reinsurer under this Agreement and that exchange or convert to a plan covered under this Agreement will not be reinsured hereunder and will be expressly excluded from coverage hereunder.
...END OF ARTICLE VIII
ARTICLE IX
CLAIMS
Claims covered under this Agreement include only claims which are those due to the death, injury or illness of the insured on a policy reinsured under this Agreement, and any additional benefits specified in Exhibit B, which are provided by the underlying policy and are reinsured under this Agreement.
1) Notice. The Reinsurer reserves the right to review any claim on a policy reinsured under this Agreement.
2) Proofs. If so requested , the Company will promptly provide the Reinsurer with proper claim proofs, including a copy of the proof of payment by the Company, and a copy of the insured's death certificate. In addition, for contestable claims, if so requested the Company will send to the Reinsurer a copy of all papers and information in connection with the claim.
3) Amount and Payment of Reinsurance Benefits. The Reinsurer will promptly pay the reinsurance benefits due the Company according to the quarterly statement process in effect under this Agreement. The Company's contractual liability for policies reinsured under this Agreement is binding on the Reinsurer. However, for claims incurred during the contestable period, if the total amount of reinsurance ceded to all reinsurers on the policy is greater than the amount retained by the Company, or if the Company retained less than its usual retention on the policy, the Company will consult with the Reinsurer in accordance with paragraph 4 below before conceding liability or making settlement to the claimant.
The total reinsurance recoverable from all companies will not exceed the Company's total contractual liability on the policy, less the amount retained. The maximum reinsurance benefit payable to the Company under this Agreement is the risk amount specifically reinsured with the Reinsurer (69%), subject to all the other provisions of the this Agreement. The Reinsurer will also pay its proportionate share of the interest that the Company pays on the death proceeds until the date of settlement except if settlement is delayed as a result of a dispute or contest arising out of conflicting claims of entitlement to policy proceeds or benefits, then the Reinsurer will pay its share of interest to the date settlement would have been made if there were no dispute or contest.
Life benefit payments will be made in a single sum, regardless of the Company's settlement options; provided, however, that such single sum will exclude interest that accrues on settlement options other than single pay.
ARTICLE IX CONTINUES...
The reinsurance benefit for an approved Waiver of Premium claim will be the Reinsurer's proportionate share of the annual gross premium waived on the policy. The Company will continue to pay the life reinsurance premium; however, it will not pay the reinsurance premium for the waiver benefit for the duration of the waiver claim period. The Reinsurer will pay waiver benefits consistent with the Company's mode of premium payment specified in the policy.
4) Contested Claims. The Company will promptly notify the Reinsurer of its intention to contest, compromise, or litigate a claim over $250,000 involving a reinsured policy. The Company will also promptly and fully disclose to the reinsurer all information relating to the claim. Upon receipt of all documents, the Reinsurer will have five (5) working days to notify the Company in writing of its decision to accept participation in the contest, compromise, or litigation. If the Reinsurer has accepted participation, the Company will promptly advise the Reinsurer of all developments in the claim investigation, including notification of any legal proceedings against it in response to denial of the claim. At the request of the Reinsurer, the Company will confer with the Reinsurer to advise it of the status of the investigation, litigation or discussions relating thereto, and will instruct any counsel retained to act on behalf of the Company in connection with the investigation, litigation or related negotiations, to confer with the Reinsurer, upon request of the Reinsurer, regarding the status of the investigation, litigation or related negotiations. In particular, the Company will arrange for the Reinsurer (should the Reinsurer request the same) to participate in discussions with the Company's counsel at the initiation of the contest and prior to the time when the Reinsurer must elect to participate or not participate in the investigation or litigation, as the case may be.
If the Reinsurer does not accept participation, the Reinsurer will then fulfill its obligation by paying the Company its full share of the reinsurance amount, and will not share in any subsequent reduction or increase in liability, and will not share in loss adjustment expenses or extracontractual obligations.
If the Reinsurer accepts participation and the Company's contest, compromise, or litigation results in a reduction or increase in liability, the Reinsurer will share in any such reduction or increase in proportion to its share of the risk on the contested policy.
5) Claim Expenses. The Reinsurer will pay its share of reasonable claim
investigation and legal expenses (not to exceed 69% of all such expenses)
connected with the litigation or settlement of contractual liability
claims unless the Reinsurer has discharged its liability pursuant to
Section IX 4) above. If the Reinsurer has so discharged its liability, the
Reinsurer will not participate in any expenses incurred thereafter.
The Reinsurer will not reimburse the Company for routine claim and administration expenses, including but not limited to the Company's home office expenses, compensation of salaried officers and employees, and any legal expenses other than third party expenses incurred by the Company (which legal expenses shall be borne as provided in the immediately preceding paragraph). Claim investigation expenses do not include expenses incurred by the Company as a result of a dispute or contest arising out of conflicting claims of entitlement to policy proceeds or benefits.
6) Misrepresentation or Suicide. If the Company returns premium to the policyowner or beneficiary as a result of misrepresentation or suicide of the insured, the Reinsurer will refund net reinsurance premiums received on that policy without interest to the Company in lieu of any other form of reinsurance benefit payable under this Agreement.
7) Misstatement of Age or Sex. In the event of a change in the amount of the Company's liability on a reinsured policy due to a misstatement of age or sex, the Reinsurer's liability will change proportionately. The face amount of the reinsured policy will be adjusted from the inception of the policy, and any difference in premiums net of allowances will be settled without interest.
8) Extra-Contractual Damages. The Reinsurer will not participate in punitive or compensatory damages that are awarded against the Company as a result of an act, omission, or course of conduct committed by the Company, its agents, or representatives in connection with claims covered under this Agreement. If the Reinsurer elected in writing to join in the contest of the coverage in question, the Reinsurer will pay its share (not to exceed 69% of all statutory penalties) of statutory penalties awarded against the Company in connection with claims covered under this Agreement.
The parties recognize that circumstances may arise in which equity would require the Reinsurer, to the extent permitted by law, to share proportionately in punitive and compensatory damages. The parties agree that such circumstances are limited to those situations in which the Reinsurer recommended in writing, consented to in writing, or ratified in writing, the act or course of conduct of the Company that ultimately resulted in the assessment of the extra-contractual damages. In such situations, the Reinsurer and the Company will share such damages so assessed, in equitable proportions.
For purposes of this Article, the following definitions will apply.
"Punitive Damages" are those damages awarded as a penalty, the amount of which is neither governed nor fixed by statute.
"Compensatory Damages" are those amounts awarded to compensate for the actual damages sustained, and are not awarded as a penalty, nor fixed in amount by statute.
"Statutory Penalties" are those amounts awarded as a penalty, but are fixed in amount by statute.
END OF ARTICLE IX
ARTICLE X
RECAPTURE
Any recapture will be based upon terms to be mutually agreeable to the Company and the Reinsurer. After the effective date of recapture, the Reinsurer will not be liable for any reinsured policies or portions of such reinsured policies eligible for recapture that the Company has overlooked. A change to the Company's maximum retention limits will not affect the reinsured policies in force except as specifically provided elsewhere in this Agreement.
...END OF ARTICLE X
ARTICLE XI
GENERAL PROVISIONS
1) Currency. All payments and reporting by both parties under this Agreement will be made in the currency specified in Exhibit C.
2) Premium Tax. The Reinsurer will reimburse the Company for premium taxes based on the reinsurer's coinsurance percentage.
3) Inspection of Records. The Reinsurer and the Company, or their duly authorized representatives, will have the right to inspect and audit original papers, records, and all documents relating to the business reinsured under this Agreement including but not limited to underwriting, claims processing, and administration. Such access will be provided during regular business hours at the office of the inspected party. The Reinsurer may suspend payments relating to matters in dispute that arise from such inspection and audit until such dispute is resolved by the parties either through mutual agreement or by arbitration in accordance with Article XIV.
4) USA Patriot Act and Blocked Persons. The Company covenants to the Reinsurer that it will comply with United States Treasury Department's Office of Foreign Assets Control and USA Patriot Act requirements (the "Laws") in connection with the payment of claims, and agrees that all claims paid by the Company in violation of the Laws will not be reinsured under this Agreement. For the avoidance of doubt, the Company acknowledges and agrees that the Reinsurer has no liability for claims paid by the Company in violation of the Laws ("Excluded Claims"); provided, however, that the Reinsurer shall reimburse the Company for all premiums received by the Reinsurer, less expense allowances (including commissions and premium taxes, etc.) paid by the Reinsurer, regarding the policies to which such Excluded Claims relate. The Company agrees to indemnify and hold harmless the Reinsurer from and against any and all sanctions, penalties, assessments and other liabilities (including the fees of counsel) suffered or incurred by the Reinsurer arising from, relating to or in connection with the payment of an Excluded Claim.
5) Off-Set. Any debts or credits, in favor of or against either the Reinsurer or the Company with respect to this Agreement are deemed mutual debts or credits and may be offset, and only the balance will be allowed or paid.
The right of offset will not be affected or diminished because of the insolvency of either party.
See Exhibit H for relevant provisions thereof.
6) Errors and Omissions. If through unintentional error, oversight, omission, or misunderstanding (collectively referred to as "errors"), the Reinsurer or the Company fails to comply with the terms of this Agreement and if, upon discovery of the error by either party, the other is promptly notified, each thereupon will be restored to the position it would have occupied if the error had not occurred, including interest.
ARTICLE XI CONTINUES...
If it is not possible to restore each party to the position it would have occupied but for the error, the parties will endeavor in good faith to promptly resolve the situation in a manner that is fair and reasonable, and most closely approximates the intent of the parties as evidenced by this Agreement.
For the avoidance of doubt, the parties agree that this paragraph 6 relates only to clerical and ministerial errors. However, the Reinsurer will not provide reinsurance for policies that do not satisfy the parameters of this Agreement, nor will the Reinsurer be responsible for negligent or deliberate acts or for repetitive errors in administration by the Company. If either party discovers that the Company has failed to cede reinsurance as provided in this Agreement, or failed to comply with its reporting requirements, the Reinsurer may require the Company to audit its records for similar errors and to take the actions necessary to avoid similar errors in the future.
7) Company Forms and Rates. The Company will furnish the Reinsurer with a copy of its application forms, policy and rider forms, premium and nonforfeiture values, reserve tables, and any other forms or tables needed for proper handling of reinsurance under this contract. The Company will advise the Reinsurer in writing of any changes to existing forms, nonforfeiture values and reserve tables, or new forms it may adopt.
...END OF ARTICLE XI
ARTICLE XII
INSOLVENCY
1) Insolvency. The Company will be deemed insolvent when it:
a. applies for or consents to the appointment of a receiver, rehabilitator, conservator, liquidator or statutory successor of its properties or assets; or
b. is adjudicated as bankrupt or insolvent; or
c. files or consents to the filing of a petition in bankruptcy, seeks reorganization to avoid insolvency or makes formal application for any bankruptcy, dissolution, liquidation or similar law or statute; or
d. becomes the subject of an order to rehabilitate or an order to liquidate as defined by the insurance code of the jurisdiction of the party's domicile.
2) Insolvency of the Company. In the event of the insolvency of the Company, all reinsurance payments due under this Agreement will be payable directly to the liquidator, rehabilitator, receiver, or statutory successor of the Company, without diminution because of the insolvency, for those claims allowed against the Company by any court of competent jurisdiction or by the liquidator, rehabilitator, receiver or statutory successor having authority to allow such claims.
In the event of insolvency of the Company, the liquidator, rehabilitator, receiver, or statutory successor will give written notice to the Reinsurer of all pending claims against the Company on any policies reinsured within a reasonable time after such claim is filed in the insolvency proceeding. While a claim is pending, the Reinsurer may investigate and interpose, at its own expense, in the proceeding where the claim is adjudicated, any defense or defenses that it may deem available to the Company or its liquidator, rehabilitator, receiver, or statutory successor.
The expense incurred by the Reinsurer will be chargeable, subject to court approval, against the Company as part of the expense of liquidation to the extent of a proportionate share of the benefit that may accrue to the Company solely as a result of the defense undertaken by the Reinsurer. Where two or more reinsurers are participating in the same claim and a majority in interest elect to interpose a defense or defenses to any such claim, the expense will be apportioned in accordance with the terms of this Agreement as though such expense had been incurred by the Company.
The Reinsurer will be liable only for the amounts reinsured and will not be or become liable for any amounts or reserves to be held by the Company on policies reinsured under this Agreement.
...END OF ARTICLE XII
ARTICLE XIII
REINSURER'S RIGHT OF NOTICE OF UNUSUAL PRACTICES
IN providing reinsurance facilities to the Company under this Agreement, the Reinsurer has granted the Company considerable authority with respect to automatic binding power, reinstatements, claim settlements, and the general administration of the reinsurance account. The Reinsurer assumes that, except as otherwise notified in writing by the Company, and agreed to in writing by the Reinsurer, the underwriting, claims and other insurance practices employed by the Company with respect to reinsurance ceded under this Agreement are consistent with the customary and usual practices of the insurance industry as a whole. Where the Company does engage in exceptional or uncustomary practices or implements a change in its underwriting rules or guidelines, with respect to business covered under this Agreement, the Company agrees to advise the Reinsurer in writing forty-five (45) days prior to implementing such practice or change and receive a written acceptance of said practice or change from the Reinsurer before assigning any liability to the Reinsurer with respect to any reinsurance issued under or impacted or effected by such practice or change. The Company acknowledges and agrees that its covenant to the Reinsurer to so advise the Reinsurer of any exceptional or uncustomary practice or implementation of such a change is a material inducement to the Reinsurer agreeing to enter into this Agreement, and absent such a covenant, the Reinsurer would not have entered into this Agreement. In the event the Company does not receive written acceptance from the Reinsurer of the proposed change in practice, or the Reinsurer declines to accept the change in practice proposed by the Company, then no liability shall be assumed by the Reinsurer with respect to any policy issued by the Company under, or effected by, such practice or change.
...END OF ARTICLE XIII
ARTICLE XIV
ARBITRATION
It is the intention of the Reinsurer and the Company that the customs and practices of the life insurance and reinsurance industry will be given full effect in the operation and interpretation of this Agreement. The parties agree to act in all matters with the highest good faith. However, if the Reinsurer and the Company cannot mutually resolve a dispute that arises out of or relates to this Agreement, the dispute will be decided through arbitration as a precedent to any right of action hereunder.
To initiate arbitration, either the Company or the Reinsurer will notify the other party in writing of its desire to arbitrate, stating the nature of its dispute and the remedy sought. The party to which the notice is sent will respond to the notification in writing within fifteen (15) days of its receipt.
There will be three arbitrators who will be current or former senior officers of life insurance or life reinsurance companies other than the parties to this Agreement, their affiliates or subsidiaries. Each of the parties will appoint one of the arbitrators and these two arbitrators will select the third. If either party refuses or neglects to appoint an arbitrator within sixty (60) days of the initiation of the arbitration, the other party may appoint the second arbitrator. If the two arbitrators do not agree on a third arbitrator within thirty (30) days of the appointment of the second arbitrator, then the appointment of the third arbitrator shall be from the ARIAS-U.S. list of certified arbitrators.
Once chosen, the arbitrators are empowered to select the site of the arbitration and decide all substantive and procedural issues by a majority of votes. As soon as possible, the arbitrators will establish arbitration procedures as warranted by the facts and issues of the particular case. The arbitrators will have the power to determine all procedural rules of the arbitration, including but not limited to inspection of documents, examination of witnesses and any other matter relating to the conduct of the arbitration. The arbitrators may consider any relevant evidence; they will weigh the evidence and consider any objections. Each party may examine any witnesses who testify at the arbitration hearing.
The arbitrators will base their decision on the terms and conditions of this Agreement and the customs and practices of the life insurance and reinsurance industries rather than on strict interpretation of the law. The decision of the arbitrators will be made by majority rule and will be submitted in writing. The decision will be final and binding on both parties and there will be no appeal from the decision. Either party to the arbitration may petition any court having jurisdiction over the parties to reduce the decision to judgment.
Unless the arbitrators decide otherwise, each party will bear the expense of its own arbitration activities, including its appointed arbitrator and any outside attorney and witness fees. The parties will jointly and equally bear the expense of the third arbitrator and other costs of the arbitration.
This Article will survive termination of this Agreement.
...END OF ARTICLE XIV
ARTICLE XV
CONFIDENTIALITY
The Company and the Reinsurer agree that Customer and Proprietary Information will be treated as confidential. Customer Information includes, but is not limited to, medical, financial, and other personal information about proposed, current, and former policyowners, insureds, applicants, and beneficiaries of policies issued by the Company. Proprietary Information includes, but is not limited to, business plans and trade secrets, mortality and lapse studies, underwriting manuals and guidelines, applications and contract forms, and the specific terms and conditions of this Agreement.
Customer and Proprietary Information will not include information that:
a. is or becomes available to the general public through no fault of the
party receiving the Customer or Proprietary Information (the "Recipient");
b. is independently developed by the Recipient;
c. is acquired by the Recipient from a third party not covered by a
confidentiality agreement; or
d. is disclosed under a court order, law or regulation.
The parties will not disclose such information to any other parties unless agreed to in writing, except as necessary for retrocession purposes, as requested by external auditors, as required by court order, or as required or allowed by law or regulation. The Company acknowledges that the Reinsurer can aggregate data with other companies reinsured with the Reinsurer provided that the Reinsurer acts reasonably to ensure that the data cannot be identified as belonging to the Company.
...END OF ARTICLE XV
ARTICLE XVI
DURATION OF AGREEMENT
This Agreement is indefinite as to its duration.
...END OF ARTICLE XVI
ARTICLE XVII
ELIGIBLE POLICIES AND EXECUTION
This Agreement is effective as of 12:01 a.m. on December 22, 2005, and applies to all eligible policies with issue dates on or before such date.
This Agreement has been made in duplicate and is hereby executed by both parties.
GREAT AMERICAN LIFE ASSURANCE COMPANY
OF PUERTO RICO
San Juan, Puerto Rico
Date: December 15, 2005 By: /s/ _____________________________ Name: Arturo Carrion Title: President Witness: _____________________________ |
SEGUROS DE VIDA TRIPLE-S, INC.
San Juan, Puerto Rico
Date: December 15, 2005 By: /s/ _____________________________ Name: Roberto Morales, Esq. Title: President Witness: _____________________________ END OF ARTICLE XVII 25 |
EXHIBIT A
RETENTION LIMITS OF THE COMPANY
A.1 LIFE INSURANCE, ACCIDENT AND SUPPLEMENTAL HEALTH INSURANCE THE COMPANY'S COINSURANCE PERCENTAGE The Company will cede 69% of each policy reinsured under this Agreement, net of third party reinsurance. A.2 WAIVER OF PREMIUM DISABILITY BENEFITS Applicable, as included with the business reinsured under this Agreement, in which case the Company shall retain an amount in the same proportion as its life insurance, accident and supplemental health insurance retention. A.3 ACCIDENTAL DEATH BENEFITS Applicable, as included with the business reinsured under this Agreement, in which case the Company shall retain an amount in the same proportion as its life insurance, accident and supplemental health insurance retention. A.4 RIDERS Applicable, as included with the business reinsured under this Agreement, in which case the Company shall retain an amount in the same proportion as life insurance, accident and supplemental health insurance retention. |
EXHIBIT B
PLANS COVERED
Policy plans, riders and benefits issued on plans with effective dates within the applicable period shown below may qualify for automatic reinsurance under the terms of this Agreement.
B.1 PLAN TYPE START DATE
Debit Life, Direct Ordinary Life December 22, 2005 Universal Life December 22, 2005 Direct Ordinary Health (Accident and Health) December 22, 2005 Debit Health (Accident and Health) December 22, 2005 Pre-need December 22, 2005 Annuities December 22, 2005 |
B.2 WAIVER OF PREMIUM DISABILITY BENEFITS Applicable, as included with the business reinsured under this Agreement, in which case the Company shall retain an amount in the same proportion as its life insurance and accident and health insurance retention. B.3 ACCIDENTAL DEATH BENEFITS Applicable, as included with the business reinsured under this Agreement, in which case the Company shall retain an amount in the same proportion as its life insurance and accident and health insurance retention. B.4 RIDERS Applicable, as included with the business reinsured under this Agreement, in which case the Company shall retain an amount in the same proportion as its life insurance and accident and health insurance retention. B.5 PLAN TYPE (FOR EACH PLAN IDENTIFIED) Life insurance and accident and health insurance reinsured under this Agreement. (The Company shall attach a complete list of policy form numbers.) B.6 Automatic Reinsurance Automatic reinsurance applies to policies placed in force prior to June 30, 2006, which date may be extended at the option of the Reinsurer. |
EXHIBIT C
AUTOMATIC BINDING LIMITS
The limits in this Exhibit C refer to insured lives and accident and health insureds reinsured under this Agreement.
C.1 LIFE REINSURANCE AND ACCIDENT AND HEALTH REINSURANCE REINSURER'S COINSURANCE PERCENTAGE The Reinsurer's share will be sixty nine percent (69%) of each policy reinsured under this Agreement, net of third party reinsurance. C.2 RECAPTURE Not Applicable. C.3 CURRENCY U.S. ($) Dollars only. C.4 TERRITORIES Territories covered under this Agreement include only the Commonwealth of Puerto Rico. |
EXHIBIT D-1
PROCEDURES FOR REPORTING
The Company will maintain adequate records to administer the reinsurance accounts and will cede reinsurance under this Agreement on a self-administration basis. The Company will provide the Reinsurer with an activity report on computer disk or other mutually agreed upon electronic media, substantially in conformity with the following:
A) QUARTERLY AND RENEWAL PREMIUM STATEMENT
The Company will provide the Reinsurer with a report of all reinsurance policies renewing during the past month(s) accompanied by reinsurance premiums for such policies which should include the following:
A) MONTHLY POLICY EXHIBIT REPORT
The Company will provide a summary of new issues, terminations, recaptures, changes, death claims and reinstatements during the month(s) and the inforce reinsurance at the end of the month.
B) QUARTERLY IN FORCE AND RESERVE LISTING
Within thirty (30) days after the close of each calendar quarter, the Company will furnish the Reinsurer with a summary showing premiums earned by line of business and by agreed upon sublines.
EXHIBIT D-2
REQUEST FOR FINANCIAL REPORTING INFORMATION
Please provide the following information as soon as practical after the close of the quarter but not later than the due date as stated in the treaty. Please provide monthly or other interim reports if available. ALL REPORTS SHOULD INCLUDE BOTH THE REINSURER'S TREATY NUMBER AS WELL AS THE COMPANY'S REFERENCE NUMBER. The Company must maintain and provide upon request, sufficiently detailed reports such that reserve calculations can be independently verified by the Reinsurer's auditors and examiners.
A) QUARTERLY REPORTING
1) Policy counts and face amount ceded.
2) Gross and tabular net due, deferred and advance premium split between first year and renewal.
3) Statutory reserves should be split between YRT and coinsurance
reserves and by type of reserve and issue year. Type of
reserve should coincide with Exhibit 5, 6, 7 and 8 of the
Annual Statement; e.g. Exhibit 5, Section A - Life Insurance,
Section B - Annuity, ... Section G - Deficiency Reserves etc.
If possible, it should also be segregated by business type,
e.g. Whole Life, Term, Universal Life, Interest Sensitive
Whole Life, etc.
4) Account value roll forward for Universal Life, Deferred Annuity and similar products.
5) Claim information - Claim Number, Policy number, Insured's Name, Business or Policy Type, Type of Reinsurance (Co or YRT), Notification Date, Date of Death, Date of Birth, Cause of Death, Claim Amount, Status (paid, pending, resisted).
6) Estimated tax reserves corresponding to the statutory reserves described above (4th quarter only). 7) Policy level detail statutory reserve listing via electronic media if practical.
B) ANNUAL STATUTORY REPORTING
1) Reserves in Exhibit 5 format (if not provided by valuation basis in quarterly reports).
2) Page 7, Analysis in Increase in Reserves.
3) Actuarial Opinion signed by the appointed actuary
4) For reserves using X-factors that are less than 100% in any duration, an actuarial opinion supported by an actuarial report with sufficient supporting documentation and detailed data to allow an independent review of the X-factors.
5) Policy Exhibit
6) Policy level detail statutory reserve listing via electronic media. 7) Exhibit reconciling detail listing to summary reports.
C) STATUTORY ANNUAL STATEMENT when published.
D) ELECTRONIC DATA TRANSMISSION.
If the Company uses electronic data transfer, the Company shall consult with the Reinsurer to determine the appropriate reporting format. Should the Company subsequently desire to make changes in the data format or the code structure, the Company shall communicate such changes to the Reinsurer prior to the use of such changes in reports.
EXHIBIT E
REINSURANCE PREMIUM RATES, ADMINISTRATIVE EXPENSE ALLOWANCES AND COMMISSION ALLOWANCES
E.1 LIFE AND ACCIDENT AND HEALTH Plans covered under this Agreement will be reinsured on a coinsurance funds withheld basis. Reinsurance premiums are equal to the gross premiums collected on the amounts retained by the company on the business reinsured multiplied by the reinsurer's coinsurance percentage. ACQUISITION EXPENSE ALLOWANCES |
POLICY TYPE BASIS FEES (PER ANNUM) ---------------------------------- ------------ --------------------------------------- Debit Life Per Policy $55.00 Direct Ordinary Life - Medical Per Policy $175.00 + 20% of first year commissions Direct Ordinary Life - Non-Medical Per Policy $50.00 + 20% of first year commissions Direct Ordinary Health Per Policy $50.00 Debit Health Per Policy $55.00 Annuities Per Policy $25.00 |
ADMINISTRATIVE EXPENSE ALLOWANCES
POLICY TYPE BASIS FEES (PER ANNUM) --------------------------- ------------ ---------------- Debit Life Per Policy $28.72 Direct Ordinary Life Per Policy $45.00 Direct Ordinary Health Per Policy $25.00 Debit Health Per Policy $28.72 Annuities Per Policy $30.00 |
COMMISSION ALLOWANCES
POLICY TYPE BASIS FEES (PER ANNUM) ---------------------------------------- ---------------------- --------------------- Debit Life Percentage of Premium First Year - 80% Renewal Years - 17.5% American Freedom Term and Universal Life Percentage of Premium First Year - 69% - 90% Varying by Plan Years 2 - 10 - 7% Years 11+ - 2% Plus Bonus Universal Life - GA Percentage of Premium First Year 80% of Target |
Life Series Years 2-10 7.5% of Target Years 11+ 3.0% of Target Years 1-10 4.5% of Excess Years 11+ 3.0% of Excess Plus Bonus Direct Ordinary Health Percentage of Premium First Year - 75% Renewal Years - 20% Debit Health Percentage of Premium First year - 71% Renewal years - 17.5% Annuities Percentage of Premium 5% in all years |
For purposes of the cash settlements described in Exhibit H, the expense allowances for each quarter shall be calculated as follows:
a. "Per policy" acquisition allowances shall be calculated as 69% of the amounts shown, multiplied by the numbers of policies of each type paid for during the quarter.
b. "per policy" administrative expense allowances shall be calculated as 69% of the amounts shown, multiplied by the average of the numbers of policies of each type inforce at the beginning and the end of the quarter.
c. Commission allowances shall be calculated on the basis of 69% of collected first year and renewal premiums for each class of policy.
d. Allowances based on percentages of commissions shall be calculated
based on commissions as described in (c) above. E.2 INITIAL CEDING ALLOWANCE $60,000,000.00 U.S. See Exhibit H. |
EXHIBIT F
ASSETS TO BE HELD IN TRUST
CUSIP SECURITY NAME --------- ----------------------------------- 912810DY1 U.S. TREASURY BONDS 8.75 5-15-17 912810DV7 U.S. TREASURY BONDS 9.25 2-15-16 912810EL8 U.S. TREASURY BONDS 8.0 11-15-21 912810DW5 U.S. TREASURY BONDS 7.25 5-15-16 912810ED6 U.S. TREASURY BONDS 8.125 8-15-19 912810EH7 U.S. TREASURY BONDS 7.875 2-15-21 912810EM6 U.S. TREASURY BONDS 7.25 8-15-22 912810DL9 U.S. TREASURY BONDS 12.50 8-15-14 912828BQ2 U.S. TREASURY BONDS 3.375 11-15-08 912810DX3 U.S. TREASURY BONDS 7.50 11-15-16 912810EP9 U.S. TREASURY BONDS 7.125 2-15-23 912810DU9 U.S. TREASURY BONDS 9.375 2-15-06 912828BK5 U.S. TREASURY NOTES 3.125 09-15-08 912828EC0 U.S. TREASURY NOTES 4.125 08-15-08 9128277B2 U.S. TREASURY NOTES 5.00 8-15-11 |
*Par amounts and interest rates should be shown for all real assets.
The parties shall make appropriate adjustments to reflect the actual amount of reserves reinsured as of December 31, 2005.
EXHIBIT G
TRUST AGREEMENT
EXHIBIT H
ACCOUNTING AND CASH TRANSFER PROVISIONS
1. Accounting and Cash Transfer Provisions
2. Initial funds withheld. No cash transfers on the Effective Date. The ceding commission and the funds withheld are accomplished as described in Article VI. As noted in Article VI, certain assets (detailed in Exhibit F) are to be held in trust by the company for the benefit of the reinsurer. Interest on these assets shall accrue to the benefit of the reinsurer from January 1, 2006, without regard to the date on which they are actually placed in the Trust.
3. Tracking from December 22 through December 31, 2005. The parties agree that for accounting purposes, actual tracking of premiums, claims, and allowances shall commence on January 1, 2006. In place of such actual tracking for the period December 22 - December 31, 2005, the parties agree to deem that the result of such tracking would have been a net payment of $400,000 from the company to the Reinsurer; such payment will be included in the first quarterly settlement.
4. First quarterly settlement. The first quarterly settlement shall be for the quarter ending March 31, 2006.
5. Elements of each quarterly settlement. The Company shall pay to the reinsurer a net amount calculated as follows (which, if negative, shall mean that the reinsurer pays the amount to the company) calculated as A x B, where A =
a. Reinsurance premiums for the quarter, calculated as in Article V
(1), on a basis consistent with the reporting of premiums on line 1
of the "Analysis of Operations by Lines of Business" page of the
statutory financial statement, minus
b. Claims for the quarter, calculated as in Article IX, on a basis consistent with the reporting of claims on lines 10 through 17 of the "Analysis of Operations by Lines of Business" page of the statutory financial statement, minus
c. Expense allowances for the quarter, calculated as set forth in Exhibit E, plus
d. (for the March 31, 2006 settlement only) $165,000, plus
e. Interest earned (whether or not received by the company) during the quarter on assets held in the trust, plus
f. An adjustment for policy loans, equal to [i1 minus i2] x [mean policy loan asset for the quarter], where i1 = net earned rate of interest for the quarter on policy loans and i2 = net earned rate of interest for the Quarter on all other assets of the Company.
And B = 1.0125 if the net payment is made within 30 days following the end of the quarter, and (1.0125 plus .0002N) otherwise, where N is the number of days in excess of 30 from the end of the quarter until the date of payment.
EXHIBIT 10.15
TRIPLE-S, INC.
US$50,000,000
6.30% Senior Unsecured Notes due September 2019
NOTE PURCHASE AGREEMENT
Dated September 30, 2004
TRIPLE-S, INC.
6.30% Senior Unsecured Notes due September 2019
September 30, 2004
THE PURCHASERS NAMED IN
THE ATTACHED SCHEDULE A:
Ladies and Gentlemen:
Triple-S Management Corporation ("TSMC") and its wholly-owned subsidiary Triple-S, Inc. (the "COMPANY"), each a corporation organized under the laws of the Commonwealth of Puerto Rico (the "COMMONWEALTH"), agree with you as follows:
1. AUTHORIZATION OF NOTES.
The Company has authorized the issuance and sale of an aggregate principal amount of Fifty Million United States Dollars (US$50,000,000) of its 6.30% Senior Unsecured Notes due September 2019 (the "NOTES," such term to include each Note delivered pursuant to this Agreement and each Note delivered in substitution or exchange for any such Note pursuant to Section 14 of this Agreement). The Notes shall be substantially in the form of Exhibit 1-A hereto and shall have the terms as herein and therein provided. The Notes will be unconditionally guaranteed as to payment of principal, premium, if any, and interest by TSMC as guarantor (in such capacity, the "GUARANTOR") pursuant to a guarantee substantially in the form of Exhibit 1-B hereto (the "GUARANTEE"). Certain capitalized terms used in this Agreement are defined in Schedule B hereto; references to a "SCHEDULE" or an "EXHIBIT" are, unless otherwise specified, to a Schedule or an Exhibit attached to this Agreement and all Schedules and Exhibits are deemed to be a part of this Agreement. References herein to this "AGREEMENT" mean this Agreement as from time to time amended or supplemented or as the terms hereof may be waived, in accordance with Section 17 hereof.
2. SALE AND PURCHASE OF NOTES.
Subject to the terms and conditions of this Agreement, the Company agrees to issue and sell to you and you agree to purchase from the Company, at the Closing provided for in Section 3, Notes in the aggregate principal amount specified opposite your name in Schedule A at the purchase price of one hundred percent (100%) of the principal amount thereof.
3. CLOSING.
The closing (the "CLOSING") of the sale and purchase of the Notes to be purchased by you shall occur at the offices of Fiddler Gonzalez & Rodriguez, P.S.C., 254 Munoz Rivera Avenue, Hato Rey, Puerto Rico 00918, at 10:00 a.m., local time, on September 30, 2004 or on such other Business Day thereafter as may be agreed upon by the Company and you. At the Closing, the
Company will deliver to you the Notes to be purchased by you in denominations of at least Five Hundred Thousand United States Dollars (US$500,000) as you may request dated the date of the Closing (the "CLOSING DATE") and registered in your name (or in the name of your nominee), against delivery by you to the Company of immediately available funds in the amount of the purchase price therefor by wire transfer to the Account 35858201 of the Company maintained at Citibank New York, Account Name Triple-S, Inc, ABA 021000089.
4. CONDITIONS TO CLOSING.
Your obligation to purchase and pay for the Notes to be delivered to you at the Closing is subject to the fulfillment, prior to or at the Closing, of the following conditions:
4.1. REPRESENTATIONS AND WARRANTIES.
The representations and warranties of the Company and the Guarantor contained in Section 5 of this Agreement shall have been true and correct as of the date of this Agreement and be true and correct at the time of the Closing as if made on and as of such time.
4.2. PERFORMANCE; NO DEFAULT.
Each of the Company and the Guarantor shall have performed and complied in all material respects with all agreements and conditions contained in this Agreement required to be performed or complied with by it prior to or at the Closing and, after giving effect to the issuance and sale of the Notes (and the application of the proceeds thereof as contemplated by Section 5.12), no Default or Event of Default shall have occurred and be continuing. Neither the Company nor the Guarantor shall have entered into any transaction since June 30, 2004, that would have been prohibited by Sections 10 or 11 hereof had such Sections applied since such date.
4.3. COMPLIANCE CERTIFICATES.
(a) Officer's Certificate. Each of the Company and the Guarantor shall have delivered to you an Officer's Certificate, dated as of the Closing Date, certifying on behalf of the Company or the Guarantor, as applicable, that the conditions specified in Sections 4.1, 4.2, 4.7 and 4.8 have been fulfilled.
(b) Secretary's Certificates. Each of the Company and the Guarantor shall have delivered to you a certificate in form and substance reasonably satisfactory to you executed on behalf of the Company or the Guarantor, as applicable, by its Secretary or Assistant Secretary certifying as to the resolutions attached thereto and other corporate proceedings relating to the authorization, execution, delivery and performance of this Agreement, the Notes and the Guarantee, as applicable. Such certificates shall state that the resolutions thereby certified have not been amended, modified, revoked or rescinded. The Secretary's certificate also shall confirm the incumbency and signature of the officers of the Company or the Guarantor, as applicable, executing this Agreement, the Notes and the
Guarantee, as applicable, and any certificate or document to be delivered to you pursuant hereto, together with evidence of the incumbency of such Secretary or Assistant Secretary.
4.4. OPINIONS OF COUNSEL.
You shall have received opinions from (a) Fiddler Gonzalez & Rodriguez, P.S.C. and (b) Hector R. Ramos, Senior Vice President, Corporate Affairs, of TSMC, as counsel for the Company and TSMC, each dated as of the Closing Date, and substantially in the respective forms set forth as Exhibits 2-A and 2-B. You also shall have received an opinion from Pietrantoni Mendez & Alvarez LLP your special counsel, dated the Closing Date in form and substance satisfactory to you. This Section 4.4 shall constitute direction by the Company and TSMC to such counsel named in the foregoing clauses (a) and (b) to deliver the opinions specified to you at the Closing.
4.5. PURCHASE PERMITTED BY APPLICABLE LAW, ETC.
On the Closing Date, the consummation of the transactions contemplated hereby shall (i) be permitted by the laws and regulations of each jurisdiction to which you are subject as an investment company organized and operating in Puerto Rico, (ii) not violate any applicable law or regulation, including without limitation, laws or regulations relating to the healthcare and insurance industries, (iii) not subject you to any tax, penalty or liability under or pursuant to any applicable law or regulation, which law or regulation was not in effect on the date hereof, and (iv) all necessary consents, approvals and authorizations of any Governmental Authority or any Person to or of such consummation shall have been obtained and shall be in full force and effect.
4.6. PRIVATE PLACEMENT NUMBER.
A Private Placement number issued by Standard & Poor's CUSIP Service Bureau (in cooperation with the Securities Valuation Office of the National Association of Insurance Commissioners) shall have been obtained for the Notes.
4.7. CHANGES IN CORPORATE STRUCTURE.
Neither the Company nor the Guarantor (or any other of the Subsidiaries of the Guarantor) shall have changed its jurisdiction of incorporation or been a party to any merger or consolidation. Neither the Company nor the Guarantor (or any such Subsidiary) shall have succeeded to all or any substantial part of the liabilities of any other entity, following the date of the most recent financial statements referred to in Schedule 5.3. There shall not have occurred any change or event, and you shall not have become aware of any previously undisclosed information regarding the Guarantor or its Subsidiaries, which in each case in your reasonable judgment, could reasonably be expected to have a Material Adverse Effect.
4.8. NO MATERIAL LITIGATION.
Except as disclosed to you pursuant to Section 5.6 hereof, no actions, suits or proceedings, investigations or orders shall be pending, entered or, to the knowledge of the Company or the Guarantor, threatened against or affecting the Company or the Guarantor,
which, in your reasonable judgment, if determined adversely to the Guarantor or the Company, could reasonably be expected to have a Material Adverse Effect.
4.9. PROCEEDINGS AND DOCUMENTS; GOOD STANDING CERTIFICATES.
All corporate and other proceedings in connection with the transactions contemplated by this Agreement and all documents and instruments incident to such transactions, including, but not limited to, the certificate of incorporation and by-laws of the Company and the Guarantor, shall be reasonably satisfactory to you and your special counsel, and you and your special counsel shall have received all such counterpart originals or certified or other copies of such documents as you or they may reasonably request. You shall have received also, copies of certificates dated as of a recent date from the Secretary of State of Puerto Rico and the Commissioner of Insurance, as applicable, evidencing the good standing of the Guarantor, the Company and its Significant Subsidiaries in Puerto Rico.
5. REPRESENTATIONS AND WARRANTIES OF THE COMPANY AND THE GUARANTOR.
The Company and the Guarantor jointly and severally represent and warrant to you as follows:
5.1. ORGANIZATION; POWER AND AUTHORITY.
Each of the Company, the Guarantor, and its Subsidiaries is a corporation duly organized, validly existing and in good standing under the laws of the Commonwealth of Puerto Rico, and is duly qualified as a foreign corporation and is in good standing in each jurisdiction in which such qualification is required by law, other than those jurisdictions as to which the failure to be so qualified or in good standing would not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect. The Company has all requisite corporate power and authority to execute, deliver and perform its obligations under this Agreement and the Notes. The Guarantor has all requisite corporate power and authority to execute, deliver and perform its obligations under this Agreement and the Guarantee. Each of the Company and the Guarantor, and each of the other Subsidiaries of the Guarantor, has the corporate power and authority to own and operate its property, to lease the property it operates as lessee and to conduct the business in which it is currently engaged.
5.2. AUTHORIZATION, ETC.
(a) This Agreement and the Notes will be duly authorized on the Closing Date by all necessary corporate action on the part of the Company, and this Agreement constitutes, and upon execution and delivery thereof by the Company, each Note, when issued, will constitute, a legal, valid and binding obligation of the Company (assuming with respect to this Agreement and any Notes issued to you, the due authorization, execution and delivery of this Agreement to you), enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies (collectively, the "ENFORCEABILITY EXCEPTIONS").
(b) This Agreement and the Guarantee will be duly authorized on the Closing Date by all necessary corporate action on the part of the Guarantor, and this Agreement constitutes, and upon execution and delivery thereof by the Guarantor, the Guarantee will constitute, a legal, valid and binding obligation of the Guarantor (assuming with respect to this Agreement and any Notes issued to you, the due authorization, execution and delivery of this Agreement to you),enforceable against the Guarantor in accordance with its terms, except to the extent that enforceability may be limited by the Enforceability Exceptions.
5.3. FINANCIAL STATEMENTS.
(a) The Company has delivered to you copies of the financial statements of the Company listed on Schedule 5.3(a) and of the Guarantor listed on Schedule 5.3(b) (such financial statements, including in each case the related schedules and notes, collectively the "FINANCIAL STATEMENTS").
(b) The Financial Statements of the Company listed on Schedule 5.3(a) fairly present in all material respects the financial position of the Company as of the respective dates specified in such Schedule and the consolidated results of its operations and cash flows for the respective periods so specified in accordance with U.S. GAAP consistently applied throughout the periods involved except as set forth in the notes thereto (subject, in the case of any interim financial statements, to normal year-end adjustments).
(c) The Financial Statements of the Guarantor listed on Schedule 5.3(b) fairly present in all material respects the consolidated financial position of the Guarantor and its Subsidiaries as of the respective dates specified in such Schedule and the consolidated results of their operations and cash flows for the respective periods so specified in accordance with U.S. GAAP consistently applied throughout the periods involved except as set forth in the notes thereto (subject, in the case of any interim financial statements, to normal year-end adjustments).
5.4. COMPLIANCE WITH LAWS, OTHER INSTRUMENTS, ETC.
(a) The execution, delivery and performance by the Company of this Agreement and the Notes and by the Guarantor of this Agreement and the Guarantee, do not and will not (i) in all material respects, contravene, result in any breach of, or constitute a default under, or result in the creation of any Lien in respect of any property of the Company or the Guarantor, as applicable, under, any indenture, mortgage, deed of trust, loan, purchase or credit agreement, lease, corporate charter or by-laws, or any other Material agreement or instrument to which the Company or the Guarantor, as applicable, is bound or by which the Company or the Guarantor, as applicable, or their respective properties may be bound or affected, (ii) contravene, result in any breach of, or constitute a default under an agreement with any Governmental Authority, (iii) conflict with or result in a breach or violation of any of the terms, conditions or
provisions of any order, judgment, decree, or ruling of any court, arbitrator or Governmental Authority applicable to the Guarantor or the Company, or (iv) violate any provision of any statute or other rule or regulation of any Governmental Authority applicable to the Guarantor or the Company.
5.5. GOVERNMENTAL AUTHORIZATIONS, ETC.
No consent, approval or authorization of, or registration, filing or declaration with, any Governmental Authority is required for the due execution, delivery or performance by the Company of this Agreement and the Notes or by the Guarantor of this Agreement and the Guarantee.
5.6. LITIGATION; OBSERVANCE OF STATUTES AND ORDERS.
(a) Except as disclosed in Schedule 5.6, there are no actions, suits or proceedings pending or, to the knowledge of the Company or the Guarantor, threatened against or affecting the Company or the Guarantor or any property of the Company or the Guarantor in any court or before any arbitrator or administrative agency of any kind or before or by any Governmental Authority that, if determined adversely to the Guarantor or the Company, individually or in the aggregate, would reasonably be expected to have a Material Adverse Effect, and no order, judgment, decree, or ruling of any court, arbitrator or Governmental Authority applicable to the Company or the Guarantor, has been issued against the Company or the Guarantor which has a Material Adverse Effect.
(b) Neither the Company nor the Guarantor is in default under any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority or in violation of any applicable law, ordinance, rule, order or regulation of any Governmental Authority, which default or violation, individually or in the aggregate, has had, or would reasonably be expected to have a Material Adverse Effect.
5.7. TAXES.
Each of the Company and the Guarantor has filed or caused to be
filed all tax returns that are required to have been filed, and has paid all
taxes shown to be due and payable on such returns and all other taxes payable by
it, to the extent such taxes have become due and payable, except for any taxes
(i) the amount of which would not individually or in the aggregate reasonably be
expected to have a Material Adverse Effect or (ii) the amount, applicability or
validity of which is currently being contested in good faith by appropriate
proceedings and with respect to which the Company or the Guarantor, as
applicable, has established adequate reserves in accordance with U.S. GAAP. The
Company and the Guarantor know of no material assessments for which adequate
reserves have not been established. Except as provided in Schedule 5.7, neither
the Company nor the Guarantor have knowledge of any tax deficiency which, if
determined adversely to the Company or the Guarantor, might have a Material
Adverse Effect.
5.8. TITLE TO PROPERTY; LEASES.
Except as disclosed in Schedule 5.8, each of the Company and the Guarantor has good and marketable title to its Material properties owned by them and reflected in the Financial Statements, as to each such property free and clear of Liens, except for those defects in title and Liens that, individually or in the aggregate, do not materially affect the value of such property and do not materially interfere with the use made and proposed to be made of such property by the Guarantor and the Company. All leases of the Company and the Guarantor for real property or buildings Material in the operation of their corresponding business activities are valid and subsisting and are in full force and effect in all material respects.
5.9. LICENSES, PERMITS, ETC.
Except as disclosed in Schedule 5.9, the Company and the Guarantor own or posses adequate rights to use all material trademarks, service marks, trade names, trademark registrations, service mark registrations, copyrights, material patents, patent applications and licenses which are necessary for the conduct of their respective businesses and have no reason to believe that the conduct or their respective businesses will conflict with, and have not received any notice of any claim of conflict with, any such rights of others, except for such claims that, individually or in the aggregate, would not have a Material Adverse Effect.
5.10. COMPLIANCE WITH ERISA.
(a) Each of the Company and the Guarantor and their respective ERISA Affiliates has operated and administered each Plan in all material respects in compliance with its terms and with all applicable laws except for such instances of noncompliance as have not resulted in and would not reasonably be expected to result in a Material Adverse Effect. None of the Company, the Guarantor or any of their respective ERISA Affiliates has incurred any liability pursuant to Title I or IV of ERISA or applicable penalty or excise tax provisions of the Code and the PRIRC relating to employee benefit plans (as defined in section 3 of ERISA), and no event, transaction or condition has occurred or exists that would reasonably be expected to result in the incurrence of any such liability by the Company, the Guarantor or any of their respective ERISA Affiliates, or in the imposition of any Lien on any of the rights, properties or assets of the Company, the Guarantor or any of their respective ERISA Affiliates, in either case pursuant to Title I or IV of ERISA or to such penalty or excise tax provisions or to section 401(a)(29) or 412 of the Code or to any comparable provisions of the PRIRC, other than in any of such cases, such liabilities or Liens as would not reasonably be expected to result, individually or in the aggregate, in a Material Adverse Effect.
(b) None of the Company, the Guarantor or any of their respective ERISA Affiliates has incurred withdrawal liabilities (and are not subject to contingent withdrawal liabilities) under section 4201 or 4204 of ERISA in
respect of Multiemployer Plans that individually or in the aggregate would reasonably be expected to result in a Material Adverse Effect.
(c) The execution and delivery of this Agreement; the issuance and
sale of the Notes hereunder and the execution and delivery of
the Guarantee will not involve any transaction that is subject
to the prohibitions of section 406 of ERISA or in connection
with which a tax could be imposed pursuant to section
4975(c)(1)(A)-(D) of the Code or comparable provisions of the
PRIRC. The representation by the Company and the Guarantor in
the first sentence of this Section 5.10(c) is made in reliance
upon and subject to (i) the accuracy of your representation in
Section 6.2 as to the sources of the funds to be used to pay
the purchase price of the Notes to be purchased by you and
(ii) the assumption, made solely for the purpose of making
such representation, that Department of Labor Interpretive
Bulletin 75-2 with respect to prohibited transactions remains
valid in the circumstances of the transactions contemplated
herein.
5.11. PRIVATE OFFERING BY THE COMPANY.
None of the Company, the Guarantor or the Agent (the only Person authorized or employed by the Company as agent, broker, dealer or finder in connection with the offering or sale of the Notes) has offered any of the Notes or any similar securities for sale to, or solicited any offer to buy any of the same from, or otherwise approached or negotiated in respect thereof with, any Person other than you. As used in the preceding sentence, "SIMILAR SECURITY" means a security which would be integrated with the offering of the Notes under applicable securities laws. None of the Company, the Guarantor or the Agent has taken, or will take, any action that would subject the issuance or sale of the Notes to the registration requirements of Section 5 of the Securities Act.
5.12. USE OF PROCEEDS; MARGIN REGULATIONS.
The Company will apply the proceeds from the sale of the Notes to repay certain outstanding short term indebtedness of the Company incurred in the Company's trade or business in Puerto Rico and for working capital and general corporate purposes of the Company's trade or business in Puerto Rico. No part of the proceeds from the sale of the Notes hereunder will be used, directly or indirectly, for the purpose of buying or carrying any margin stock within the meaning of Regulation U of the Board of Governors of the Federal Reserve System (12 CFR 207), or for the purpose of buying or carrying or trading in any securities under such circumstances as to involve the Company in a violation of Regulation X of said Board (12 CFR 224) or to involve any broker or dealer in a violation of Regulation T of said Board (12 CFR 220). As used in this Section, the terms "MARGIN STOCK" and "PURPOSE OF BUYING OR CARRYING" shall have the meanings assigned to them in said Regulation U.
5.13. EXISTING INDEBTEDNESS FOR BORROWED MONEY.
Except as described therein, Schedule 5.13 sets forth a complete and correct list of all outstanding Indebtedness for Borrowed Money in the principal amount of at least Five
Million United States Dollars (US$5,000,000) of the Guarantor and the Company as of June 30, 2004, since which date there has been no material change in the amounts, interest rates, sinking funds, installment payments or maturities of such Indebtedness for Borrowed Money. Neither the Company nor the Guarantor is in default (and no waiver of any such default is currently in effect) in the payment of any principal or interest on, and no event of default exists with respect to, any such Indebtedness for Borrowed Money or any indebtedness (other than Indebtedness for Borrowed Money) by the Guarantor, the Company or any Significant Subsidiary in excess of One Million United States Dollars (US$1,000,000).
5.14. FOREIGN ASSETS CONTROL REGULATIONS, ETC.
None of the sale of the Notes by the Company hereunder, its use of the proceeds thereof or the execution and delivery of the Guarantee by the Guarantor will violate the Trading with the Enemy Act, as amended, or any of the foreign assets control regulations of the United States Treasury Department (31 CFR, Subtitle B, Chapter V, as amended) or any enabling legislation or executive order relating thereto.
5.15. STATUS UNDER CERTAIN STATUTES.
Neither the Company nor the Guarantor is subject to regulation under the Investment Company Act of 1940, as amended, the Public Utility Holding Company Act of 1935, as amended, the Interstate Commerce Act, as amended, or the Federal Power Act, as amended.
5.16. DISCLOSURE.
Neither this Agreement nor any agreement, document, certificate or statement furnished to you by the Company or the Guarantor in connection with the offer and sale of the Notes contains any untrue statement of material fact or, taken together with all other information furnished to you by the Company or the Guarantor, omits to state a material fact necessary in order to make the statements contained herein or therein not misleading. All pro forma financial statements made available to you have been prepared in good faith based upon reasonable assumptions.
5.17. CHANGES IN CONDITION.
Since June 30, 2004, there has been no change in the capital stock or long-term debt of the Guarantor, nor any labor dispute or court or governmental action, order or decree, or, to the knowledge of the Company or of the Guarantor, no development or event, which has had, or could reasonably be expected to have, a Material Adverse Effect.
5.18. SUBSIDIARIES.
The Company has no Subsidiaries as of the date hereof. The Guarantor has no Subsidiaries other than those set forth in Schedule 5.18. All of the issued shares of capital stock of the Guarantor have been duly and validly authorized and issued, and are fully paid and non-assessable. All of the issued shares of capital stock of the Company and each other Subsidiary of the Guarantor have been duly and validly authorized and issued, and are fully paid and non-
assessable, and (except for directors' qualifying shares or as set forth in Schedule 5.18) are owned directly or indirectly by the Guarantor. The capital stock and securities owned by the Guarantor in each of its Subsidiaries are owned free and clear of any Lien or restriction on the transfer thereon other than restrictions imposed by such Subsidiaries' respective certificates of incorporations or bylaws to the transfer of their respective capital stock or securities, applicable securities or insurance laws and restrictions and Liens outstanding on the date hereof and listed in said Schedule 5.18.
5.19. BUSINESS ACTIVITY.
The Company is principally engaged in the business of providing health insurance, including, but not limited to, the sale of long term care insurance and other healthcare services.
5.20. SOURCE OF INCOME.
All interest to be paid under the Notes will, for purposes of the
Code, constitute income from sources within the Commonwealth. In order to comply
with said Commonwealth source of income requirement under the present provisions
of the Code, (i) interest on the Notes shall not be treated as paid by a trade
or business conducted by the Company outside Puerto Rico, such determination to
be made under Section 884(f)(1)(A) of the Code and the regulations thereunder;
and (ii) for the three year period ending with the close of the Company's
taxable year immediately preceding the payment of interest on the Notes (or such
portion of such period as may be applicable), the Company either: (a) derived
more than 20% of its gross income from sources within the Commonwealth; or (b)
derived more than 20% of its gross income from the conduct of a trade or
business in the Commonwealth, both tests determined under the provisions of
Section 861(c)(1)(B) of the Code.
5.21. EMPLOYEE MATTERS.
No labor disturbance by the employees of the Company or the Guarantor exist or, to the knowledge of the Company or the Guarantor, is imminent, which may be expected to have a Material Adverse Effect.
5.22. BOOKS AND RECORDS.
The Company and the Guarantor (i) make and keep accurate books and records and (ii) maintain internal accounting controls which provide reasonable assurance that (A) transactions are executed in accordance with management's authorization, (B) transactions are recorded as necessary to permit preparation of their respective financial statements in conformity with U.S. GAAP and to maintain accountability for its assets, (C) access to its assets is permitted only in accordance with management's authorization and (D) the reported accountability for their respective assets is compared with existing assets at reasonable intervals.
6. REPRESENTATIONS OF THE PURCHASER.
You hereby represent and warrant to the Company and the Guarantor as follows:
6.1. PURCHASE FOR INVESTMENT; ACCREDITED INVESTOR.
(a) You are purchasing the Notes for your own account and not with a view to, or for sale in connection with, the distribution thereof within the meaning of the Securities Act, provided that you have the right to dispose of the Notes, or any part thereof, if you deem it advisable to do so, either pursuant to a registration of the Notes under the Securities Act or pursuant to an applicable exemption from the registration requirements of the Securities Act. You understand that neither the Notes nor the Guarantee has been registered under the Securities Act or the Puerto Rico Uniform Securities Act ("PRUSA") and you understand and agree that the Notes may be resold only if registered pursuant to the provisions of the Securities Act or if an exemption from registration is available thereunder.
(b) You are an "ACCREDITED INVESTOR" as defined in Rule 501(a) under the Securities Act.
(c) It is understood that, in making the representations set out in Sections 5.4, 5.5 and 5.10 hereof, each of the Company and the Guarantor is relying, to the extent applicable, upon your representations set forth in this Section 6.1.
(d) (a) You have consulted with your own legal, regulatory, tax,
business, investment, financial and accounting advisers in
connection herewith to the extent you have deemed necessary,
(b) you have had a reasonable opportunity to ask questions of
and receive answers from officers and representatives of the
Company and the Guarantor concerning their respective
financial condition and results of operations and any other
matter relevant to the purchase of the Notes, and any such
questions have been answered to your satisfaction, (c) you
have had the opportunity to review all publicly available
records and filings concerning the Guarantor and its
subsidiaries including the Company and you have carefully
reviewed such records and filings as you considered relevant
to making an investment decision, and (d) you have made your
own investment decisions based upon your own judgment, due
diligence and advice from such advisers as you have deemed
necessary and not upon any view expressed by the Company or
the Guarantor.
6.2. SOURCE OF FUNDS.
At least one of the following statements is an accurate representation as to each source of funds (a "SOURCE") to be used by you to pay the purchase price of the Notes to be purchased by you hereunder:
(a) all or part of the Source constitutes assets of a bank collective investment fund, as contemplated by PTE 91-38, maintained by you, and you have disclosed to the Company the names of such employee benefit plans whose assets in such bank collective investment fund exceed ten percent (10%) of the total assets or are expected to exceed ten percent (10%) of the total assets of such fund as of the date of such purchase (for the purpose of this clause (a), all employee benefit plans maintained by the same employer or employee organization are deemed to be a single plan); or
(b) all or part of the Source constitutes assets of one or more employee benefit plans, each of which has been identified to the Company in writing; or
(c) you are acquiring the Notes for the account of one or more pension funds, trust funds or agency accounts, each of which is a "GOVERNMENTAL PLAN" (as defined in section 3(32) of ERISA) and the investment does not give rise to any violation of any federal, state or local law which is substantially similar to Title I of ERISA, section 4975 of the Code or comparable provisions of the PRIRC; or
(d) the Source is an "INVESTMENT FUND" managed by a "QUALIFIED PROFESSIONAL ASSET MANAGER" or "QPAM" (as defined in Part V of PTE 84-14, issued March 13, 1984), provided that (i) no other party to the transaction described in this Agreement and no "AFFILIATE" of such party (as defined in Part V(c) of PTE 84-14) has at this time, and during the immediately preceding one year none has exercised, the authority to appoint or terminate said QPAM as manager of the assets of any plan identified in writing pursuant to this clause (f) or to negotiate the terms of said QPAM's management agreement on behalf of any such identified plans, (ii) the conditions set forth in paragraphs (c), (d), (e), (f) and (g) of Part I of PTE 84-14 are satisfied; and (iii) you have disclosed to the Company the name of the QPAM and of all employee benefit plans whose assets are included in such investment fund;
(e) the Source is a "PLAN" managed by an "IN-HOUSE ASSET MANAGER" or "INHAM" (as defined in Part IV of PTE 96-23, issued April 10, 1996), provided that the conditions set forth in paragraphs (a), (c), (d), (e), (f), (g) and (h) of Part I of PTE 96-23 are satisfied; or
(f) none of such funds consists of assets of any "EMPLOYEE BENEFIT PLAN" as defined in ERISA or any "PLAN" as defined in section 4975 of the Code or comparable provisions of the PRIRC, other than an employee benefit plan or plan exempt from the coverage of ERISA and section 4975 of the Code.
As used in this Section 6.2, the terms "EMPLOYEE BENEFIT PLAN", "GOVERNMENTAL PLAN", "PARTY IN INTEREST" and "SEPARATE ACCOUNT" shall have the respective meanings assigned to such terms
in section 3 of ERISA. If you breach any representation made by you under this
Section 6.2, your purchase of the Notes shall be void ab initio.
6.3. ANTI-MONEY LAUNDERING
(a) to the best of your knowledge, the funds that you are using to purchase the Notes were not directly or indirectly derived from activities that may contravene federal, state and international laws and regulations, including Anti-Money Laundering Laws; and
(b) to the best of your knowledge, neither:
(i) you, nor
(ii) any person controlling, controlled by, or under common control with, you,
(1) is a country, territory, individual or entity named on an Office of Foreign Assets Control ("OFAC") list, or is an individual or entity that resides or has a place of business in a country or territory named on such lists, (2) is a "senior foreign political figure," or any "immediate family member" or "close associate" (as such terms are defined in the Patriot Act) of a senior foreign political figure or (3) is a "foreign shell bank" (as defined in the Patriot Act) or transacts business with a foreign shell bank.
You understand that the Company may not accept any payments for the Notes from you if you cannot make the representations set forth above.
6.4. TRANSFEREE.
Any transferee of a Note shall, by its acceptance of such Note, be deemed to have made the same representations regarding the purchase of the Notes as the original holder thereof made pursuant to Sections 6.1, 6.2 and 6.3 above.
7. INFORMATION AS TO THE COMPANY AND THE GUARANTOR.
7.1. FINANCIAL AND BUSINESS INFORMATION.
The Company shall deliver to you and to any subsequent holder of Notes that is an Institutional Investor:
(a) Quarterly Statements--within sixty (60) days after the end of each quarterly fiscal period in each fiscal year of the Company:
(i) an unaudited balance sheet of the Company as at the end of such quarter; and
(ii) statements of income and cash flows of the Company for such quarter and (in the case of the second and third quarters) for the portion of the fiscal year ending with such quarter,
setting forth in each case in comparative form the figures for the corresponding periods in the previous fiscal year, all in reasonable detail, and certified by a Senior Financial Officer of the Company as fairly presenting, in accordance with U.S. GAAP, the financial position of the Company and its results of operations and cash flows, subject to changes resulting from year-end adjustments;
(b) Annual Statements of the Guarantor--within one hundred twenty (120) days after the end of each fiscal year of the Guarantor:
(i) a consolidated balance sheet of the Guarantor, as at the end of such year; and
(ii) consolidated statements of income and cash flows of the Guarantor for such year,
setting forth in each case in comparative form the figures for the previous fiscal year, all in reasonable detail, prepared in accordance with U.S. GAAP, and accompanied by an opinion thereon of independent certified public accountants of recognized national standing and reputation, which opinion shall state that such financial statements present fairly the financial position of the Guarantor and its results of operations and cash flows in conformity with U.S. GAAP and that the examination of such accountants in connection with such financial statements has been made in accordance with generally accepted auditing standards consistently applied;
(c) SEC and Other Reports of the Guarantor -- for so long as the Guarantor is subject to reporting obligations under the Securities Exchange Act of 1934 (as amended from time to time) with respect to any of its securities, promptly, and in any event within ten (10) days upon their becoming available, one copy of (i) each financial statement, report, notice or proxy statement sent by the Guarantor to public securities holders generally, and (ii) each regular or periodic report, each registration statement that shall have become effective (with exhibits except as otherwise expressly requested by such holder), and each final prospectus and all amendments thereto filed by the Guarantor with the Securities and Exchange Commission ("SEC"); provided, however, that no such delivery shall be required as to any of such reports which have been required to be filed and are available in electronic format from the SEC's EDGAR database. In the event that the Guarantor is at any time no longer subject to the reporting requirements of the Securities and Exchange Act of 1934, the Guarantor shall provide to you and each subsequent note holder that is an Institutional Investor, at your request, (i) a quarterly presentation which shall include a discussion by the Guarantor's management of the most
recent financial and operational results of the Guarantor and its Significant Subsidiaries on a consolidated basis and a discussion of the Guarantor's most recent business plans and projections, and (ii) on a yearly basis, a written report reflecting a discussion by the Guarantor's management of the financial and operational results of the Guarantor and its Significant Subsidiaries on a consolidated basis as of the year ended. In addition, on a quarterly basis, the Guarantor's designated legal counsel, at your request, will provide you and your designated legal counsel, access to material and recent information so as to provide an update to the status of the actions, suits or proceedings specified in Schedule 5.6.
(d) Notice of Default or Event of Default -- promptly, and in any event within ten (10) days, after a Responsible Officer becoming aware of the existence of any condition or event which constitutes a Default or Event of Default, a written notice specifying the nature and period of existence thereof and what action the Company or the Guarantor, as applicable, is taking or proposes to take with respect thereto;
(e) Notices from Governmental Authority -- promptly, and in any event within 30 days of receipt thereof, copies of any notice to the Company or the Guarantor, as applicable, from any federal, state or Commonwealth Governmental Authority relating to any order, ruling, statute or other law or regulation that could reasonably be expected to have a Material Adverse Effect; and
(f) Requested Information -- such other data and information directly relating to the ability of the Company to perform its obligations hereunder and under the Notes or of the Guarantor to perform its obligations hereunder or under the Guarantee as from time to time may be reasonably requested by any holder of Notes.
7.2. OFFICER'S CERTIFICATE.
Each set of financial statements delivered to you or to any other holder of Notes pursuant to Section 7.1(a) as of 7.1(b) hereof shall be accompanied by a certificate of a Senior Financial Officer of the Company or the Guarantor, as applicable, setting forth on behalf of the Company or the Guarantor, as applicable, a statement that the Company or the Guarantor, as applicable, has no knowledge of any Default or Event of Default, or if the Company or the Guarantor, as applicable, has such knowledge, specifying such Default or Event of Default, the nature thereof and the action taken or proposed to be taken by the Company or the Guarantor, as applicable, with respect thereto.
7.3. INSPECTION.
Each of the Company and the Guarantor shall permit each holder of Notes that is an Institutional Investor, or a group of Affiliated Institutional Investors that are original purchasers and holders of Notes, and holds Notes with an aggregate principal amount of at least
Ten Million United States Dollars (US$10,000,000) or Five Million United States Dollars (US$5,000,000) in the case of such group, together with its representatives, at the expense of the Company or the Guarantor, as applicable, if done in connection with a Default or an Event of Default, to visit and inspect any of the offices or properties of the Company or the Guarantor, as applicable, to examine its books and records, and to discuss its affairs, finances and accounts with its officers, employees and independent public accountants (and by this provision, each of the Company and the Guarantor authorizes said accountants to discuss the finances and affairs of the Company or the Guarantor, as applicable, but any such discussions shall be arranged by the Company or the Guarantor, as applicable, and the Company or the Guarantor, as applicable, shall have the opportunity to participate therein) all at such reasonable times and as may be reasonably requested in relation to the performance by the Company of its obligations under the Notes or by the Guarantor of its obligations under the Guarantee or by the Company or the Guarantor under this Agreement; provided, however, that neither the Company nor the Guarantor shall be required to disclose to any such holder of Notes (or to any of its representatives) information to the extent that the Company or the Guarantor, as applicable, is advised by internal or external legal counsel that it is prohibited from disclosing such information at such time to its creditors generally under applicable laws, rules, regulations or orders (or other binding restrictions imposed by Governmental Authorities or agreements entered into in good faith with third parties that are not Affiliates of the Company or the Guarantor, as applicable).
8. PAYMENT OF INTEREST
The Company shall pay interest (computed on the basis of a 360-day
year of twelve 30-day months) (a) on the unpaid balance of the Notes at the rate
of six and three tenths percent (6.30%) per annum from the date of the Notes,
payable semiannually, on the fifteenth (15th) day of March and the fifteenth
(15th) day of September in each year, commencing on March 15, 2005, until the
principal hereof shall have become due and payable, provided, however, that in
the event that the rating of the Notes by Standard & Poor's falls below "BBB-",
or the rating of the Notes by A.M. Best Company, Inc. falls below "bbb-" (each a
"RATINGS EVENT"), then the interest on the unpaid balance thereof shall become
payable at the rate of seven percent (7.00%) per annum from the date of such
event and (b) to the extent permitted by law, on any overdue payment (including
any overdue prepayment) of principal and any overdue payment of interest,
payable semiannually as aforesaid (or, at the option of the registered holder
hereof, on demand), at a rate per annum from time to time equal to the Default
Rate. Within 90 days following the occurrence of a Ratings Event, the Company
shall have the right to redeem the Notes without premium, at its option, in
whole but not in part, at any time, in accordance with the provisions of Section
9 hereof.
9. REDEMPTION OF THE NOTES PRIOR TO MATURITY.
9.1. OPTIONAL REDEMPTION.
The Company may, at its option, upon notice as provided below, redeem and prepay prior to maturity, all or any part of the Notes on September 15 or March 15 of each year; provided, however, that, except as provided in the third paragraph of this Section 9.1, the
Company may not redeem all or any part of the Notes pursuant to this Section 9.1 prior to September 15, 2007. On and after September 15, 2007, the Notes shall be redeemable at a price equal to the percentage of the principal amount of the Notes to be redeemed specified for the periods listed below, together with accrued and unpaid interest, if any, to the date of redemption specified by the Company (the "REDEMPTION DATE").
Redemption Periods Percentage of Principal Amount ----------------------------------- ------------------------------ September 15, 2007 - March 14, 2008 102.00% March 15, 2008 - September 14, 2008 101.50% September 15, 2008 - March 14, 2009 101.00% March 15, 2009 - September 14, 2009 100.50% September 15, 2009 and thereafter 100.00% |
The Company will give each holder of Notes written notice of any redemption under this Section 9.1 not less than sixty (60) days and not more than ninety (90) days prior to any Redemption Date. Each such notice shall specify the Redemption Date, the aggregate principal amount of the Notes to be redeemed on such Redemption Date, which shall not be in an amount less than Five Million United States Dollars (US$5,000,000) and increments of US$500,000, the principal amount of each Note held by such holder to be redeemed (determined in accordance with Section 9.2), and the interest to be paid on such Redemption Date with respect to such principal amount being redeemed.
The Company shall also have the right to redeem the Notes, at its option, in whole but not in part, at any time, within 90 days following the occurrence of a Ratings Event or a, at any time, after the occurrence of a Taxable Event as provided in Section 10.6(b) hereof, subject to the notice provisions set forth in the preceding paragraph. In the case of redemption pursuant to a Ratings Event, the Company may redeem without payment of a premium. In the case of a redemption pursuant to a Taxable Event, the Company may redeem, at any time, subject to the payment of a premium pursuant to the first paragraph of this Section 9.1; provided however that if the Notes are redeemed before September 15, 2007, said redemption pursuant to a Taxable Event is subject to the payment of a premium equal to 102% of the principal amount of the Notes so redeemed.
9.2. ALLOCATION OF PARTIAL REDEMPTIONS.
In the case of each partial redemption of the Notes, the principal amount of the Notes to be redeemed shall be allocated among all of the Notes at the time outstanding in proportion, as nearly as practicable, to the respective unpaid principal amounts thereof not theretofore called for redemption.
9.3. MATURITY; SURRENDER, ETC.
In the case of each redemption of Notes pursuant to this Section 9, the principal amount of each Note to be redeemed shall mature and become due and payable on the respective Redemption Date, together with interest on such principal amount accrued to such date. From and after such date, unless the Company shall fail to pay such principal amount when so due and payable, together with the interest thereon, interest on such principal amount shall cease to accrue. Any Note paid or redeemed in full shall be surrendered to the Company and cancelled and shall not be reissued, and no Note shall be issued in lieu of any prepaid principal amount of any Note.
9.4. PURCHASE OF NOTES.
Neither the Company nor the Guarantor will, and neither the Company nor the Guarantor will permit any of their respective Affiliates to, purchase, redeem, prepay or otherwise acquire, directly or indirectly, any of the outstanding Notes except upon the payment or redemption of the Notes in accordance with the terms of this Agreement and the Notes. The Company will promptly cancel all Notes acquired by it or any of its Affiliates (including the Guarantor) pursuant to any payment, redemption or purchase of Notes pursuant to any provision of this Agreement and no Notes may be issued in substitution or exchange for any such Notes.
10. COMPANY AND GUARANTOR BUSINESS COVENANTS.
The Company and the Guarantor jointly and severally covenant that so long as the Notes are outstanding:
10.1. COMPLIANCE WITH LAWS; MAINTENANCE OF LICENSES, ETC.
Each of the Company and the Guarantor will comply (and the Guarantor will further cause each of its other Subsidiaries to comply) with all laws, ordinances and governmental rules and regulations to which it is subject, including, without limitation, laws, ordinances and governmental rules and regulations relating to the healthcare and insurance industries, the Environmental Laws and Anti-Money Laundering Laws, and will obtain and maintain in effect (and the Guarantor will further cause each of its other Subsidiaries to obtain and maintain in effect) all licenses, certificates, permits, franchises, qualifications and other governmental authorizations (including, without limitation, those qualifications with respect to solvency and capitalization) necessary to the ownership of its properties or to the conduct of its businesses, in each case to the extent necessary to ensure that non-compliance with such laws, ordinances or governmental rules or regulations or failures to obtain or maintain in effect such licenses, certificates, permits, franchises, qualifications and other governmental authorizations would not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect.
10.2. INSURANCE.
Except where the failure to comply would not reasonably be expected to a Material Adverse Effect, each of the Company and the Guarantor will maintain, and the Guarantor shall cause each of its other Subsidiaries to maintain, with financially sound and
reputable insurers, insurance with respect to its respective properties and businesses against such casualties, risks and contingencies, of such types, on such terms and in such amounts (including deductibles, co-insurance and self-insurance, if adequate reserves are maintained with respect thereto) as is customary in the case of entities of established reputations engaged in the same or a similar business and similarly situated.
10.3. PAYMENT OF TAXES.
Each of the Company and the Guarantor will file all tax returns required to be filed and will pay and discharge or cause to be paid or discharged all taxes shown to be due and payable on such returns and all other taxes, assessments and governmental charges payable by it, to the extent such taxes, assessments and charges have become due and payable, provided that neither the Company nor the Guarantor need not pay any such tax, assessment or charge if (i) the amount, applicability or validity thereof is contested by the Company or the Guarantor, as applicable, on a timely basis in good faith and in appropriate proceedings, and each of the Company and the Guarantor has established adequate reserves therefor in accordance with U.S. GAAP on the books of the Company or the Guarantor, as applicable, or (ii) the expected nonpayment of all such taxes and assessments in the aggregate would not reasonably be expected to have a Material Adverse Effect.
10.4. USE OF PROCEEDS.
The Company will apply the proceeds from the sale of the Notes to repay certain outstanding short term indebtedness of the Company incurred in the Company's trade or business in Puerto Rico and for working capital and general corporate purposes of the Company's trade or business in Puerto Rico within a period no longer than twenty four (24) months from the date of the issuance of the Notes and will notify the Puerto Rico Treasury Department ("Treasury") of such use as required by Section 1013A of the PRIRC.
In the event that a favorable ruling from Treasury is obtained, by purchasing the Notes, the holders of the Notes, other than the Purchasers, will be deemed to have made an election under Section 1013A of the PRIRC and the 10% preferential withholding tax will be made on the interest on the Notes unless the holder elects out of such withholding by providing a written statement to that effect to the Company, through certified mail, in the form set forth in Exhibit 3.
10.5. CORPORATE EXISTENCE, ETC.
Subject to the provisions of Section 11.2 hereof, each of the Company and the Guarantor will (and the Guarantor shall cause each of its other Subsidiaries to) at all times preserve and keep in full force and effect and in good standing its corporate existence and all rights, privileges and franchises; provided, however, that the Company and the Guarantor shall not be required to preserve any such right or franchise if the Company and the Guarantor shall determine that the preservation thereof is no longer desirable in the conduct of the business of the Guarantor or the applicable Subsidiary, including the Company, and that the loss thereof is not disadvantageous in any material respect to the holders.
10.6. SOURCE OF INCOME FOR TAX PURPOSES.
(a) The Company shall do or cause to be done all things necessary or proper within its control to ensure that, for purposes of the Code, interest paid on the Notes will constitute income from sources within the Commonwealth. If the Company violates the covenant set forth in this Section, the Company shall pay additional interest to each holder that submits a claim in writing to the Company to the effect that it has or will be required to pay United States income taxes in respect of interest paid or accrued on the Notes held by such holder. The amount of such additional interest will be equal, with respect to any period, to the sum of (i) any income taxes such holder was or will be required to pay with respect to interest paid or accrued on the Notes held by such holder during such period, and with respect to payments of additional interest under this Section, after giving effect to any credit relating to such interest that such holder is entitled to take, and (ii) any penalties and interest that have been or will be assessed against such holder with respect to the late payment of such taxes. The Company shall pay to any Institutional Investor that is a Commonwealth registered investment company, any penalties or fines imposed by a Governmental Authority as a result of the Company's failure to comply with this covenant.
(b) In the event of a Taxable Event, the Company may, at its option, and upon notice, redeem prior to maturity, all of the Notes with premium, and accrued and unpaid interest, if any, to the date of redemption specified by the Company pursuant to the provisions of Section 9.1 hereof.
10.7. MAINTENANCE OF PROPERTIES.
Each of the Company and the Guarantor shall (and the Guarantor shall cause each of its other Significant Subsidiaries to) keep its material properties in good working order and condition and will comply at all times with the terms of all material leases and other material agreements to which it is a party so as to prevent any material loss or forfeiture thereof or thereunder unless compliance with such leases or agreements is being contested in good faith by appropriate proceedings and if the Company or the Guarantor, as applicable, shall have established adequate reserves therefor in accordance with U.S. GAAP on the books of the Company or the Guarantor (or such other Significant Subsidiary), as applicable.
10.8. BUSINESS ACTIVITY.
The Company will continue to be principally engaged in the business of providing health insurance including, but not limited to, the sale of life insurance in connection with the sale of health insurance, the sale of long term care insurance and other healthcare services.
11. NEGATIVE COVENANTS.
The Company and the Guarantor jointly and severally covenant that so long as any of the Notes is outstanding, shall not:
11.1. TRANSACTIONS WITH AFFILIATES.
Without the prior written consent of the Majority Holders, either
the Company or the Guarantor enter into directly or indirectly any transaction
or group of related transactions which, in the opinion of management of the
Company or the Guarantor, as applicable, is Material to the Company or the
Guarantor, as applicable (including without limitation the purchase, lease, sale
or exchange of properties of any kind or the rendering of any service) with any
of their respective Affiliates, unless management to the Company or the
Guarantor, as applicable, has determined in good faith that such transaction or
group of related transactions is or are fair and reasonable and as favorable to
the Company or the Guarantor, as applicable, as terms that would be obtainable
at the time for a comparable transaction or group of related transactions in
arm's-length dealings with an unrelated third Person. The restrictions of this
Section shall not apply to transactions between the Guarantor and its
wholly-owned Subsidiaries or between wholly-owned Subsidiaries.
11.2. CONSOLIDATION, MERGER AND SALE OF ASSETS.
Either the Company or the Guarantor consolidate with or merge into, or convey, transfer or lease its properties and assets substantially as an entity to, any Person, unless:
(a) the Company or the Guarantor, as applicable, is the surviving or continuing entity, or the entity formed by such consolidation or into which the Company or the Guarantor, as applicable, is merged or to which the Company or the Guarantor, as applicable, has conveyed, transferred or leased its properties and assets substantially as an entirety is an entity organized and validly existing under the laws of the United States of America, any province or state thereof or the District of Columbia or the Commonwealth of Puerto Rico, and such entity expressly assumes the Company's obligations under the Notes and this Agreement or the Guarantor's obligations under the Guarantee and this Agreement, as the case may be;
(b) immediately after giving effect to the transaction, no Default or Event of Default shall have occurred and be continuing; and
(c) the Company or the Guarantor, as applicable, shall have delivered to each holder an Officer's Certificate and an opinion of counsel, each stating that such consolidation, merger or transfer and such supplemental agreement, comply with this Agreement.
11.3. LIMITATION UPON CREATION OF LIENS ON VOTING STOCK OF PRINCIPAL INSURANCE OR HMO SUBSIDIARY.
Without the prior written consent of the Majority Holders, the Guarantor will not, and it will not permit any Subsidiary at any time directly or indirectly to, incur, issue, assume or guarantee any Indebtedness for Borrowed Money secured by a Lien in any shares of voting stock of any Principal Insurance or HMO Subsidiary without making effective provision whereby the Notes (and, if the Guarantor so elects, any other indebtedness of the Guarantor ranking on a
parity with the Notes) shall be secured equally and ratably with such secured indebtedness; provided, however, that the foregoing covenant shall not be applicable to Liens for taxes or assessments or governmental charges not then due and delinquent or the validity of which is being contested in good faith or which are less than Five Million United States Dollars (US$5,000,000) in amount, Liens created or resulting from any litigation or legal proceeding which is currently being contested in good faith by appropriate proceedings or which involve claims of less than Five Million United States Dollars (US$5,000,000), or deposits to secure (or in lieu of) surety, stay, appeal or custom bonds.
If the Guarantor shall hereafter be required to secure the Notes equally and ratably with any other indebtedness of the Guarantor pursuant to this Section, (i) the Guarantor and the Company shall promptly deliver to the holders an Officer's Certificate stating that the foregoing covenant has been complied with, and an opinion of counsel stating that in the opinion of such counsel the foregoing covenant has been complied with and that any instruments executed by the Guarantor or any Subsidiary in the performance of the foregoing covenant comply with the requirements of the foregoing covenant and (ii) the holders shall enter into any agreement supplemental hereto and to take such action, if any, as the Majority Holders may deem advisable to enable the holders to enforce their rights as holders of Notes so secured.
11.4. LIMITATION UPON DISPOSITION OF VOTING STOCK OF PRINCIPAL INSURANCE SUBSIDIARY.
Subject to Section 11.2, the Guarantor will not sell, assign, transfer or otherwise dispose of any shares of, securities convertible into or options, warrants or rights to subscribe for or purchase shares of, voting stock (other than directors' qualifying shares) of any Principal Insurance or HMO Subsidiary and will not permit any Principal Insurance or HMO Subsidiary to issue (except to the Guarantor) any shares of, securities convertible into or options, warrants or rights to subscribe for or purchase shares of, voting stock of any Principal or HMO Insurance Subsidiary, except for sales, assignments, transfers or other dispositions that:
(a) Are for fair market value on the date thereof, as determined by the Board of directors of the Guarantor (which determination shall be conclusive) and, after giving effect to such disposition and to the possible dilution, the Guarantor will own not less than 80% of the shares of voting stock of such Principal Insurance or HMO Subsidiary then issued and outstanding free and clear of any Lien;
(b) are made in compliance with an order or a court or regulatory authority of competent jurisdiction, as a condition imposed by any such court authority permitting the acquisition by the Guarantor, directly or indirectly, of any other insurance company or health maintenance organization or entity the activities of which are legally permissible for a holding company of such entities or a subsidiary thereof to engage in, or as an undertaking made to such authority in connection with such an acquisition; or
(c) are made where such Principal Insurance or HMO Subsidiary (if other than the Company), having obtained any necessary regulatory approvals,
unconditionally guarantees payment when due of the principal of and premium, if any, and interest on the Notes.
12. EVENTS OF DEFAULT.
An "EVENT OF DEFAULT" shall exist if any of the following conditions or events shall occur and be continuing:
(a) failure to pay interest on the Notes for more than five (5) days after the payment is due; or
(b) failure to pay principal or premium, if any, on any Note when due, whether at maturity, upon redemption, by declaration of acceleration or otherwise; or
(c) any breach by the Company of Sections 10.4 or 10.8 hereof; or
(d) any breach by the Company or the Guarantor of Sections 11.2, 11.3 or 11.4 hereof; or
(e) any breach by the Company or the Guarantor of Sections 7 or 11.1 hereof, which breach remains unremedied for fifteen (15) days; or
(f) any breach by the Guarantor of the Guarantee; or
(g) failure by the Company or the Guarantor to observe or perform in any material respect any other covenant contained herein for thirty (30) days after a holder gives written notice to the Company or the Guarantor, as applicable, thereof; or
(h) a default under any bond, debenture, note or other evidence of Indebtedness for Borrowed Money or under any mortgage, indenture or instrument under which there may be issued or by which there may be secured or evidenced any Indebtedness for Borrowed Money by the Guarantor, the Company, or any Significant Subsidiary in excess of Five Million United States Dollars (US$5,000,000) (including this Agreement), whether such indebtedness now exists or shall hereafter be created, which default shall have resulted in such indebtedness becoming or being declared due and payable prior to the date on which it would otherwise have become due and payable, without such acceleration having been rescinded or annulled within a period of 30 days after there shall have been given a written notice specifying such default; provided, however, that if such default shall be remedied or cured by the Guarantor, the Company or the Significant Subsidiary or waived by the holders of such indebtedness, then the Event of Default hereunder by reason thereof shall be deemed likewise to have been thereupon remedied, cured or waived without any action on the part of any of the holders; or
(i) the entry of a decree or order by a court having jurisdiction in the premises adjudging the Company or the Guarantor (or any such other Significant Subsidiary) a bankrupt or insolvent, or approving as properly filed a petition seeking reorganization, arrangement, adjustment or composition of or in respect of the Company or the Guarantor (or any such other Significant Subsidiary) under any applicable United States federal, Commonwealth, state or provincial bankruptcy, insolvency, reorganization or other similar law, or appointing a receiver, liquidator, assignee, trustee, sequestrator or other similar official of the Company or the Guarantor (or any such other Significant Subsidiary) or of any substantial part of their property or ordering the winding up or liquidation of their affairs, and the continuance of any such decree or order unstayed and in effect for a period of 60 days; or
(j) the institution by the Company or the Guarantor (or any such other Significant Subsidiary) of proceedings to be adjudicated a bankrupt or insolvent, or the consent by it to the institution of bankruptcy or insolvency proceedings against it, or the filing by it of a petition or answer or consent seeking reorganization or relief under any applicable United States federal, Commonwealth, state or provincial bankruptcy, insolvency, reorganization or other similar law, or the consent by it to the filing of any such petition or to the appointment of a receiver, liquidator, assignee, trustee, sequestrator or other similar official of the Company or the Guarantor (or any such other Significant Subsidiary) or of any substantial part of their property, or the making by the Company or the Guarantor (or any such other Significant Subsidiary) of a general assignment for the benefit of creditors, or the admission by it in writing of its inability to pay its debts generally as they become due and its willingness to be adjudicated a bankrupt, or the taking of corporate action by the Company or the Guarantor (or any such other Significant Subsidiary) in furtherance of any such action; or
(k) any judgment or decree, which is firm and final, for the payment of money in an amount which equals or exceeds 5% of the Company's or the Guarantor's, as applicable, consolidated stockholder's equity, as set forth in the most recent annual or quarterly financial statements of the Company or the Guarantor, as applicable, shall be rendered against the Company or the Guarantor and shall not be fully covered by insurance.
13. REMEDIES ON DEFAULT, ETC.
13.1. ACCELERATION.
(a) If an Event of Default with respect to the Company or the Guarantor described in paragraph (i) or (j) of Section 12 has occurred, all the Notes then outstanding shall automatically become immediately due and payable without any declaration or other act on the part of any holder.
(b) If any Event of Default described in any other paragraph of
Section 12 has occurred and is continuing, each holder may, at
its option, by notice given to the Company as provided for
herein, declare all the Notes held by such holder to be
immediately due and payable.
Upon any Notes becoming due and payable under this Section 13.1, whether automatically or by declaration, such Notes will forthwith mature and the entire unpaid principal amount of such Notes, plus all accrued and unpaid interest thereon (to the full extent permitted by applicable law), shall all be immediately due and payable, in each and every case without presentment, demand, protest or further notice, all of which are hereby waived.
13.2. OTHER REMEDIES.
If any Default or Event of Default has occurred and is continuing, and irrespective of whether the Notes have become or have been declared immediately due and payable under Section 13.1, each holder may proceed to protect and enforce its rights by an action at law, suit in equity or other appropriate proceeding, whether for the specific performance of any agreement contained herein, in the Notes or the Guarantee, or for an injunction against a violation of any of the terms hereof or thereof, or in aid of the exercise of any power granted hereby or thereby or by law or otherwise.
13.3. RESCISSION.
At any time after the Notes have been declared due and payable pursuant to clause (a) or (b) of Section 13.1, by written notice to the Company, the Majority Holders may rescind and annul any such declaration and its consequences if (i) the Company has paid all overdue interest on the Notes, all principal of (and premium, if any, on) the Notes that are due and payable and are unpaid other than by reason of such declaration, and all interest on such overdue principal and (to the extent permitted by applicable law) any overdue interest in respect of the Notes, at the Default Rate, (ii) all Events of Default and Defaults, other than non-payment of amounts that have become due solely by reason of such declaration, have been cured or have been waived pursuant to Section 17, and (iii) no judgment or decree has been entered for the payment of any monies due pursuant hereto, to the Notes or the Guarantee. No rescission and annulment under this Section 12.3 will extend to or affect any subsequent Event of Default or Default or impair any right consequent thereon.
13.4. NO WAIVERS OR ELECTION OF REMEDIES, EXPENSES, ETC.
No course of dealing and no delay in exercising any right, power or remedy shall operate as a waiver thereof or otherwise prejudice a holder's rights, powers or remedies. No right, power or remedy conferred by this Agreement, by the Notes or the Guarantee shall be exclusive of any other right, power or remedy referred to herein or therein or now or hereafter available at law, in equity, by statute or otherwise. All available remedies are cumulative. Without limiting the obligations of the Company under Section 15, the Company will pay on demand such further amount as shall be sufficient to cover all reasonable out-of-pocket costs and expenses incurred in any enforcement or collection under this Section 12, including, without limitation, reasonable attorneys' fees, expenses and disbursements.
14. REGISTRATION; EXCHANGE; SUBSTITUTION OF NOTES.
14.1. REGISTRATION OF NOTES.
The Company shall keep at its principal executive office a register for the registration and registration of transfers of the Notes. The name and address of each holder of one or more Notes, each transfer thereof and the name and address of each transferee of one or more Notes shall be registered in such register. Prior to due presentment for registration of transfer, the Person in whose name any Note shall be registered shall be deemed and treated as the owner and holder thereof for all purposes hereof, and the Company shall not be affected by any notice or knowledge to the contrary. If and as applicable, the Company shall give to any holder of a Note that is an Institutional Investor promptly upon request therefor, a complete and correct copy of the names and addresses of all registered holders of Notes.
14.2. TRANSFER AND EXCHANGE OF NOTES.
Upon surrender of any Note at the principal executive office of the Company for registration of transfer or exchange (and in the case of a surrender for registration of transfer, duly endorsed or accompanied by a written instrument of transfer duly executed by the registered holder of such Note or his attorney duly authorized in writing and accompanied by the address for notices of each transferee of such Note or part thereof), the Company shall execute and deliver, at the Company's expense (except as provided below), one or more new Notes (as requested by the holder thereof) in exchange therefor, in an aggregate principal amount equal to the unpaid principal amount of the surrendered Note. Each such new Note shall be payable to such Person as such holder may request and shall be substantially in the form of Exhibit 1. Each such new Note shall be dated and bear interest from the date to which interest shall have been paid on the surrendered Note or dated the date of the surrendered Note if no interest shall have been paid thereon. The Company may require payment of a sum sufficient to cover any stamp tax or governmental charge imposed in respect of any such transfer of Notes. Notes shall not be transferred in denominations of less than One Million United States Dollars (US$1,000,000), provided that if necessary to enable the registration of transfer by a holder of its entire holding of Notes, one Note may be in a denomination of less than One Million United States Dollars (US$1,000,000). Any transferee, by its acceptance of a Note registered in its name (or the name of its nominee), shall be deemed to have made the representations set forth in Sections 6.1, 6.2, 6.3 and 6.4.
14.3. REPLACEMENT OF NOTES.
Upon receipt by the Company of evidence reasonably satisfactory to it of the ownership of and the loss, theft, destruction or mutilation of any Note (which evidence shall be, in the case of an Institutional Investor which is the registered holder, notice from such Institutional Investor of such ownership and such loss, theft, destruction or mutilation), and
(a) in the case of loss, theft or destruction, of indemnity reasonably satisfactory to it (provided that if the holder of such Note is, or is a nominee for, the Purchaser or another Institutional Investor with a minimum net worth of at least One Hundred Million United States Dollars
(US$100,000,000), such Person's own unsecured agreement of indemnity shall be deemed to be satisfactory), or
(b) in the case of mutilation, upon surrender and cancellation thereof,
the Company at its own expense shall execute and deliver, in lieu thereof, a new Note, dated and bearing interest from the date to which interest shall have been paid on such lost, stolen, destroyed or mutilated Note or dated the date of such lost, stolen, destroyed or mutilated Note if no interest shall have been paid thereon.
15. PAYMENTS ON NOTES.
15.1. PLACE OF PAYMENT.
Subject to Section 15.2, payments of principal and interest becoming due and payable on the Notes shall be made in San Juan, Puerto Rico at the principal office of the Company in such jurisdiction. The Company may at any time, by notice to each holder of a Note, change the place of payment of the Notes so long as such place of payment shall be either a principal office of the Company in Puerto Rico or a principal office of a bank or trust company in Puerto Rico.
15.2. HOME OFFICE PAYMENT.
So long as you or your nominee shall be the holder of any Note, and
notwithstanding anything contained in Section 15.1 or in such Note to the
contrary, the Company will pay all sums becoming due on such Note for principal,
and interest by the method and at the address specified for such purpose below
your name in Schedule A, or by such other method or at such other address as you
shall have from time to time specified to the Company in writing for such
purpose, without the presentation or surrender of such Note or the making of any
notation thereon, except that upon written request of the Company made
concurrently with or reasonably promptly after payment or redemption in full of
any Note, you shall surrender such Note for cancellation, reasonably promptly
after any such request, to the Company at its principal executive office or at
the place of payment most recently designated by the Company pursuant to Section
15.1. Prior to any sale or other disposition of any Note held by you or your
nominee you will, at your election, either endorse thereon the amount of
principal paid thereon and the last date to which interest has been paid thereon
or surrender such Note to the Company in exchange for a new Note or Notes
pursuant to Section 14.2. The Company will afford the benefits of this Section
15.2 to any Institutional Investor that is the direct or indirect transferee of
any Note purchased by you under this Agreement and that has made the same
agreement relating to such Note as you have made in this Section 15.2.
16. SURVIVAL OF REPRESENTATIONS AND WARRANTIES; ENTIRE AGREEMENT.
The representations and warranties contained in Section 5 shall survive the execution and delivery of this Agreement, the Notes and the Guarantee and the purchase or transfer by you of any Note or portion thereof or interest therein, and may be relied upon by any subsequent holder of a Note, regardless of any investigation made at any time by or on behalf of you or any other
holder of a Note. All statements contained in any certificate or other instrument delivered by or on behalf of the Company or the Guarantor, as applicable, pursuant to this Agreement shall be deemed representations and warranties of the Company or the Guarantor, as applicable, under this Agreement. Subject to the preceding sentence, this Agreement, the Notes and the Guarantee embody the entire agreement and understanding among you, the Company and the Guarantor and supersede all prior agreements and understandings relating to the subject matter hereof.
17. AMENDMENT AND WAIVER.
17.1. REQUIREMENTS.
This Agreement, the Notes and the Guarantee may be amended, and the
observance of any term hereof or of the Notes or the Guarantee may be waived
(either retroactively or prospectively), with (and only with) the written
consent of you, the Company and the Guarantor in the case of this Agreement, you
and the Company in the case of the Notes, and you and the Guarantor in the case
of the Guarantee, except that (a) no amendment or waiver of any of the
provisions of Sections 1, 2, 3, 4, 5 or 6 hereof, or any defined term (as it is
used therein), will be effective as to you unless consented to by you in
writing, and (b) no such amendment or waiver may, without the written consent of
the holder of each Note at the time outstanding affected thereby, (i) subject to
the provisions of Section 13 relating to acceleration or rescission, change the
amount or time of any redemption or payment of principal of, or reduce the rate
or change the time of payment or method of computation of interest on, the
Notes, (ii) change the percentage of the principal amount of the Notes the
holders of which are required to consent to any such amendment or waiver, or
(iii) amend any of Sections 7, 8, 9, 10, 11, 12, 13, 17 or 20.
17.2. SOLICITATION OF HOLDERS OF NOTES.
(a) Solicitation. The Company will provide each holder of the Notes (irrespective of the amount of Notes then owned by it) with the same information provided to any other holders with respect to any proposed amendment, waiver or consent in respect of any of the provisions hereof, of the Notes or of the Guarantee. The Company will deliver executed or true and correct copies of each amendment, waiver or consent effected pursuant to the provisions of this Section 17 to each holder of outstanding Notes promptly following the date on which it is executed and delivered by, or receives the consent or approval of, the requisite holders of Notes.
(b) Payment. The Company will not directly or indirectly pay or cause to be paid any remuneration, whether by way of supplemental or additional interest, fee or otherwise, or grant any security, to any holder of Notes as consideration for or as an inducement to the entering into by any holder of Notes or any waiver or amendment of any of the terms and provisions hereof, of the Notes or the Guarantee, unless such remuneration is concurrently offered (and paid if accepted) or paid, or security is concurrently offered (and granted if accepted) or granted, on the same
terms, ratably to each holder of Notes then outstanding even if such holder did not consent to such waiver or amendment.
17.3. BINDING EFFECT, ETC.
Any amendment or waiver consented to as provided in this Section 17 applies equally to all holders of Notes and is binding upon them and upon each future holder of any Note and upon the Company or the Guarantor, as the case may be, without regard to whether such Note has been marked to indicate such amendment or waiver. No such amendment or waiver will extend to or affect any obligation, covenant, agreement, Default or Event of Default not expressly amended or waived or impair any right consequent thereon. No course of dealing between the Company and the holder of any Note or the Guarantor and the holder of any Note and no delay in exercising any rights hereunder or under any Note or the Guarantee shall operate as a waiver of any rights of any holder of such Note.
17.4. NOTES HELD BY COMPANY, ETC.
Solely for the purpose of determining whether the holders of the requisite percentage of the aggregate principal amount of Notes then outstanding approved or consented to any amendment, waiver or consent to be given under this Agreement, the Notes, or the Guarantee or have directed the taking of any action provided herein, in the Notes or the Guarantee to be taken upon the direction of the holders of a specified percentage of the aggregate principal amount of Notes then outstanding, Notes directly or indirectly owned by the Company, the Guarantor or any of their respective Affiliates shall be deemed not to be outstanding.
17.5 CONSENT OF MAJORITY HOLDERS.
Whenever consent of the holders of Notes is required by this Agreement, the Company will request the consent of such holders through written notice to each holder of record. The Company may engage the services of a third party in order to assist the Company to obtain consent of said holders of the Notes.
18. NOTICES.
All notices and communications provided for hereunder shall be in writing
and sent (a) by telecopy if the sender on the same day sends a confirming copy
of such notice by a recognized overnight delivery service (charges prepaid), or
(b) by registered or certified mail with return receipt requested (postage
prepaid), or (c) by a recognized overnight delivery service (with charges
prepaid). Any such notice must be sent:
(a) if to you or your nominee, to you or it at the address specified for such communications in Schedule A, or at such other address as you or it shall have specified to the Company in writing,
(b) if to any other holder of any Note, to such holder at such address as such other holder shall have specified to the Company in writing,
(c) if to the Company, to the Company at 1441 F.D. Roosevelt
Avenue, Sixth Floor, San Juan, Puerto Rico 00920, Attention:
President, or at such other address as the Company shall have
specified to the holder of each Note in writing, or
(d) if to the Guarantor, to the Guarantor at 1441 F.D. Roosevelt
Ave., Sixth Floor, San Juan, Puerto Rico 00920, Attention:
Chief Executive Officer or at such other address as the
Guarantor shall have specified to the holder of each Note in
writing.
Notices under this Section 18 will be deemed given only when actually received.
19. REPRODUCTION OF DOCUMENTS.
This Agreement and all documents relating thereto, including, without limitation, (a) consents, waivers and modifications that may hereafter be executed, (b) documents received by you at the Closing (except the Notes themselves), and (c) financial statements, certificates and other information previously or hereafter furnished to you, may be reproduced by you by any photographic, photostatic, microfilm, microcard, miniature photographic or other similar process and you may destroy any original document so reproduced. The Company agrees and stipulates that, to the extent permitted by applicable law, any such reproduction shall be admissible in evidence as the original itself in any judicial or administrative proceeding (whether or not the original is in existence and whether or not such reproduction was made by you in the regular course of business) and any enlargement, facsimile or further reproduction of such reproduction shall likewise be admissible in evidence. This Section 19 shall not prohibit the Company or any other holder of Notes from contesting any such reproduction to the same extent that it could contest the original, or from introducing evidence to demonstrate the inaccuracy of any such reproduction.
20. CONFIDENTIAL INFORMATION.
For the purposes of this Section 20, "CONFIDENTIAL INFORMATION" means information delivered to you by or on behalf of the Company, the Guarantor or any of their respective Affiliates in connection with the transactions contemplated by or otherwise pursuant to this Agreement that is clearly marked or labeled or otherwise adequately identified when received by you as being confidential information of the Company, the Guarantor or such Affiliate, provided that such term does not include information that (a) was publicly known or otherwise known to you prior to the time of such disclosure, (b) subsequently becomes publicly known through no act or omission by you or any person acting on your behalf or (c) otherwise becomes known to you other than through disclosure by or on behalf of the Company, the Guarantor or any of their respective Affiliates or as a result of a breach of a confidentiality agreement (which breach is known to you). You will maintain the confidentiality of such Confidential Information and will not disclose it to other Persons and (except in connection with your holding of Notes and exercise of rights under the Notes or this Agreement) will not use it, provided that you may deliver or disclose Confidential Information to (i) your directors, officers, employees, agents, attorneys and affiliates (to the extent such disclosure reasonably relates to the administration of the investment represented by your Notes and provided such recipients are advised of the
confidential nature of such information), (ii) your financial advisors and other
professional advisors (to the extent such disclosure reasonably relates to your
investment in the Notes) who agree to hold confidential the Confidential
Information substantially in accordance with the terms of this Section 20, (iii)
any other holder (unless known by you to be a competitor of the Company) of any
Note, (iv) any Institutional Investor (unless known by you to be a competitor of
the Company) to which you sell or offer to sell such Note or any part thereof or
any participation therein (if such Person has agreed in writing prior to its
receipt of such Confidential Information to be bound by the provisions of this
Section 20), (v) any Person (unless known by you to be a competitor of the
Company) from which you offer to purchase any security of the Company (if such
Person has agreed in writing prior to its receipt of such Confidential
Information to be bound by the provisions of this Section 20), (vi) as may be
required by any federal, Commonwealth or state regulatory authority having
jurisdiction over you, (vii) as may be required by any nationally recognized
rating agency that requires access to information about your investment
portfolio, or (viii) any other Person to which such delivery or disclosure may
be necessary (w) to effect compliance with any law, rule, regulation or order
applicable to you, (x) in response to any subpoena or other legal process, (y)
in connection with any litigation to which you are a party or (z) if an Event of
Default has occurred and is continuing, to the extent you may reasonably
determine such delivery and disclosure to be necessary in the enforcement or for
the protection of the rights and remedies under your Notes and this Agreement.
Each holder of a Note, by its acceptance of a Note, will be deemed to have
agreed to be bound by and to be entitled to the benefits of this Section 20 as
though it were a party to this Agreement. Without limiting the foregoing, on
reasonable request by the Company in connection with the delivery to any holder
of a Note of Confidential Information required to be delivered to such holder
under this Agreement or requested by such holder under this Agreement, such
holder will enter into a separate agreement with the Company embodying and
confirming the provisions of this Section 20.
21. MISCELLANEOUS.
21.1. SUCCESSORS AND ASSIGNS.
All covenants and other agreements contained in this Agreement by or on behalf of any of the parties hereto bind and inure to the benefit of their respective successors and assigns (including, without limitation, any subsequent holder of a Note) whether so expressed or not.
21.2. PAYMENTS DUE ON NON-BUSINESS DAYS.
Anything in this Agreement or the Notes to the contrary notwithstanding, any payment of principal of or interest on any Note that is due on a date other than a Business Day shall be made on the next succeeding Business Day without including the additional days elapsed in the computation of the interest payable on such next succeeding Business Day.
21.3. SEVERABILITY.
Any provision of this Agreement that is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or
unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall (to the full extent permitted by law) not invalidate or render unenforceable such provision in any other jurisdiction.
21.4. CONSTRUCTION.
Each covenant contained herein shall be construed (absent express provision to the contrary) as being independent of each other covenant contained herein, so that compliance with any one covenant shall not (absent such an express contrary provision) be deemed to excuse compliance with any other covenant. Where any provision herein refers to action to be taken by any Person, or which such Person is prohibited from taking, such provision shall be applicable whether such action is taken by such Person or on such Person's behalf. Titles and headings of the sections of this Agreement appear as a matter of convenience only and shall not affect the construction hereof. The words "HEREIN," "HEREOF," "HEREUNDER" and "HERETO" refer to this Agreement as a whole. The term "INCLUDING" means "INCLUDING WITHOUT LIMITATION" whether or not so expressed. All currencies used herein are U.S. dollars.
21.5. COUNTERPARTS.
This Agreement may be executed in any number of counterparts, each of which shall be deemed an original but all of which together shall constitute one instrument. Each counterpart may consist of a number of copies hereof, each signed by less than all, but together signed by all, of the parties hereto.
21.6. GOVERNING LAW.
This Agreement shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the law of the Commonwealth of Puerto Rico without giving effect to any principles of conflicts of law which might apply the laws of any other jurisdiction.
* * * * *
If you are in agreement with the foregoing, please so indicate by signing the acceptance on the accompanying counterpart of this Agreement and return it to the Company, whereupon this Agreement shall become a binding agreement among you and the Company and the Guarantor.
Very truly yours,
TRIPLE-S, INC.
TRIPLE - S MANAGEMENT CORPORATION
The foregoing is hereby agreed to as of the date thereof.
First Puerto Rico Tax-Exempt Target Maturity Fund I, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund II, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund III, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund IV, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund V, Inc.
First Puerto Rico Tax-Exempt Fund, Inc.
First Puerto Rico Target Maturity Income Opportunities Fund I, Inc.
SCHEDULE A
INFORMATION RELATING TO PURCHASERS
Principal Amount of Name and Address of Purchasers Notes to be Purchased ----------------------------------------------------------------------- --------------------- 1.) First Puerto Rico Tax-Exempt Target Maturity Fund I, Inc. 1.) $ 2,700,000 2.) First Puerto Rico Tax-Exempt Target Maturity Fund II, Inc. 2.) $ 4,250,000 3.) First Puerto Rico Tax-Exempt Target Maturity Fund III, Inc. 3.) $ 4,125,000 4.) First Puerto Rico Tax-Exempt Target Maturity Fund IV, Inc. 4.) $ 5,025,000 5.) First Puerto Rico Tax-Exempt Target Maturity Fund V, Inc. 5.) $ 4,850,000 6.) First Puerto Rico Tax-Exempt Fund, Inc. 6.) $ 9,050,000 7.) First Puerto Rico Target Maturity Income Opportunities Fund I, Inc. 7.) $20,000,000 |
Schedule A-1
All payments by wire transfer of immediately available funds to:
Citibank, N.A.
ABA 021000089
For further credit to each Purchaser's DDA acct:
1.) First Puerto Rico Tax-Exempt Target Maturity Fund I, Inc.
DDA acct 36780627
2.) First Puerto Rico Tax-Exempt Target Maturity Fund II, Inc.
DDA acct 36200856
3.) First Puerto Rico Tax-Exempt Target Maturity Fund III, Inc.
DDA acct 36203168
4.) First Puerto Rico Tax-Exempt Target Maturity Fund IV, Inc.
DDA acct 36205649
5.) First Puerto Rico Tax-Exempt Target Maturity Fund V, Inc.
DDA acct 36207648
6.) First Puerto Rico Tax-Exempt Fund, Inc.
DDA acct 36207513
7.) First Puerto Rico Target Maturity Income Opportunities Fund Inc.
DDA acct 36240639
with sufficient information to identify the source and application of such funds.
Schedule A-2
All notices of payments and written confirmations of such wire transfers
Santander Asset Management
Suite 900, 221 Ponce de Leon Ave
Hato Rey, Puerto Rico 00917-1825
Att: Frank Serra Operations Vice-President
(3) All other communications:
Telephone 787-759-5342
Telefax 787-296-5435
(4) Notes are to be delivered to:
Santander Asset Management Corporation, as investment advisor for the Purchasers
Schedule A-3
SCHEDULE B
DEFINED TERMS
As used herein, the following terms have the respective meanings set forth below or set forth in the section hereof following such term:
"AFFILIATE" means, at any time, and with respect to any Person, any other Person that at such time directly or indirectly through one or more intermediaries Controls, or is Controlled by, or is under common Control with, such first Person. Unless the context otherwise clearly requires, any reference to an "AFFILIATE" is a reference to an Affiliate of the Company or the Guarantor, as the case may be.
"ANTI-MONEY LAUNDERING LAWS" means all applicable laws, rules, regulations and other requirements relating to applicable anti-money laundering rules, including the USA Patriot Act of 2001 (the "PATRIOT ACT"), the regulations administered by the U.S. Department of Treasury's Office of Foreign Assets Control thereunder and other applicable U.S. and non-U.S. anti-money laundering laws, statutes, regulations and internal rules in connection therewith.
"BUSINESS DAY" means any day other than a Saturday, a Sunday or a day on which commercial banks in San Juan, Puerto Rico are required or authorized to be closed.
"CLOSING" is defined in Section 3.
"CODE" means the United States Internal Revenue Code of 1986, as amended from time to time, and the rules and regulations promulgated thereunder from time to time.
"COMMISSIONER OF INSURANCE" means the Office of the Commissioner of Insurance of the Commonwealth of Puerto Rico.
"COMMONWEALTH" means the Commonwealth of Puerto Rico.
"COMPANY" means Triple-S, Inc., a Puerto Rico corporation.
"CONFIDENTIAL INFORMATION" is defined in Section 20.
"CONTROL" (and the correlative terms thereof) means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a Person, whether through the ownership of voting securities, by contract or otherwise.
"DEFAULT" means an event or condition the occurrence or existence of which would, with the lapse of time or the giving of notice or both, become an Event of Default.
"DEFAULT RATE" means that rate of interest that is the greater of
(i) two percent (2%) per annum above the rate of interest stated in clause (a)
of the first paragraph of the Notes or (ii) two percent (2%) over the rate of
interest publicly announced from time to time by
Schedule B-1
Citibank, N.A., in New York City as its "BASE" or "PRIME" rate for U.S. dollar commercial loans.
"ENVIRONMENTAL LAWS" means any and all federal, state, Commonwealth, local, and foreign statutes, laws, regulations, ordinances, rules, judgments, orders, decrees, permits, concessions, grants, franchises, licenses, agreements or governmental restrictions relating to pollution and the protection of the environment or the release of any materials into the environment, including but not limited to those related to hazardous substances or wastes, air emissions and discharges to waste or public systems, or to public or employee health or safety.
"ERISA" means the Employee Retirement Income Security Act of 1974, as amended from time to time, and the rules and regulations promulgated thereunder from time to time in effect.
"ERISA AFFILIATE" means any trade or business (whether or not incorporated) that is treated as a single employer together with the Company under section 414 of the Code.
"EVENT OF DEFAULT" is defined in Section 12.
"GOVERNMENTAL AUTHORITY" means
(a) the government of
(i) the United States of America, the Commonwealth of Puerto Rico, any State of the United States, or other political subdivision thereof, or
(ii) any jurisdiction in which the Company, TSMC or any of TSMC's Subsidiaries conducts all or any part of its business, or which asserts jurisdiction over any properties of the Company, or TSMC or any of TSMC's Subsidiaries, or
(b) any entity exercising executive, legislative, judicial, regulatory or administrative functions of, or pertaining to, any such government, including, but not limited to the Commissioner of Insurance.
"GUARANTEE" is defined in Section 1.
"GUARANTOR" means TSMC.
"HOLDER" means, with respect to any Note, the Person in whose name
such Note is registered in the register maintained by the Company pursuant to
Section 14.1.
"INDEBTEDNESS FOR BORROWED MONEY" means any obligation (whether present or future or secured or unsecured) for the payment or repayment of money borrowed or raised (whether or not for a cash consideration), by whatever means (including deposits and financial leasing or under or pursuant to any letter of credit (once such letter of credit shall have been drawn upon) to secure financial accommodation, promissory note, certificate of deposit or like
Schedule B-2
instrument (whether negotiable or otherwise) or any acceptance credit facility, note purchase facility or bill acceptance or discounting facility or like arrangement entered into) by any Person in order to enable it to finance its operations or capital requirements; it being acknowledged that reimbursement obligations in respect of advance payments made by or on behalf of third party customers in relation to purchase orders to the Company are not "INDEBTEDNESS FOR BORROWED MONEY."
"INSTITUTIONAL INVESTOR" means (a) any original purchaser of a Note and (b) any bank, trust company, savings and loan association or other financial institution, any pension plan, any investment company, any insurance company, any broker or dealer, trust, corporation, partnership or any other similar financial institution or entity, regardless of legal form that is an "accredited investor" as defined in Rule 501(a) under the Securities Act; provided, however, that any investment company licensed under the laws of the Commonwealth and exempt from registration under the Investment Company Act of 1940 which otherwise meets the criteria of an "accredited investor" under Rule 501(a), shall qualify as an "INSTITUTIONAL INVESTOR".
"LIEN" means any mortgage, pledge, lien, hypothecation, prior claim, security interest, preference or other charge or encumbrance and any deferred purchase, sale-and-purchase or sale-and-leaseback arrangement and any other security agreement or preferential arrangement of a like or similar effect; for clarification, it is understood that "LIEN" does not include any arrangement whatsoever (whether a deferred purchase, sale-and-purchase, sale-and-leaseback, leasing or other arrangement) the direct or indirect purpose and effect of which is to allow or to assist the purchaser or user of a product marketed by the Company or the Guarantor to finance the acquisition or rental thereof, in whole or in part, with a third party.
"MAJORITY HOLDERS" means the holders of Notes representing in the aggregate a majority in aggregate outstanding principal amount of the Notes.
"MATERIAL" means, with respect to any Person, material in relation to the business, operations, affairs, financial condition, assets, or properties of such Person and its Subsidiaries taken as a whole; provided that for purposes of this Agreement, any amount or obligation shall be deemed to be "Material" if it equals or exceeds 10% of the Company's or the Guarantor's, as applicable consolidated stockholder's equity, as set forth in the most recent annual or quarterly financial statements of the Company or the Guarantor, as applicable, to be delivered to the holders of the Notes.
"MATERIAL ADVERSE EFFECT" means a material adverse effect on (a) the business, assets, operations or condition (financial or otherwise) of (i) the Company or (ii) the Guarantor and its Subsidiaries, including the Company, taken as a whole, (b) the ability of the Company to perform its obligations under this Agreement or the Notes or the Guarantor to perform its obligations under this Agreement or the Guarantee, (c) the validity or enforceability against the Company of this Agreement or the Notes or the validity or enforceability against the Guarantor of this Agreement or the Guarantee, or (d) the rights and remedies of the holders with respect to the Company and the Guarantor under this Agreement, the Notes or the Guarantee.
"MULTIPLE EMPLOYER PENSION PLAN" means any employee benefit plan within the meaning of section 3(3) of ERISA (other than a Multiemployer Plan), subject to Title IV of
Schedule B-3
ERISA, to which the Company or any ERISA Affiliate and an employer (as such term is defined in section 3 of ERISA) other than an ERISA Affiliate or the Company contribute.
"MULTIEMPLOYER PLAN" means any Plan that is a "MULTIEMPLOYER PLAN" (as such term is defined in section 4001(a)(3) of ERISA).
"NOTES" is defined in Section 1.
"OFFICER'S CERTIFICATE" means, with respect to any Person, a certificate of a Senior Financial Officer or of any other officer of such Person whose responsibilities extend to the subject matter of such certificate.
"OPINION OF COUNSEL" means a written opinion of counsel from legal counsel who is acceptable to the Majority Holders. The counsel may be an employee of, or external counsel to, the Guarantor or the Company.
"PERSON" means an individual, partnership, corporation, limited liability company, association, trust, unincorporated organization or a government or agency or political subdivision thereof.
"PLAN" means an "EMPLOYEE BENEFIT PLAN" (as defined in section 3(3) of ERISA) that is or, within the preceding five years, has been established or maintained, or to which contributions are or, within the preceding five years, have been made or required to be made, by the Company or any ERISA Affiliate or with respect to which the Company or any ERISA Affiliate may have any liability.
"PRINCIPAL INSURANCE OR HMO SUBSIDIARY" means any Subsidiary of the Guarantor, including its Subsidiaries, which (1) is principally engaged in the healthcare and medical insurance business as an insurance company or a health maintenance organization or in the casualty insurance business, and (2) meets any of the following conditions: (i) the Guarantor's and its other Subsidiaries' investments in and advances to the Subsidiary exceed 30 percent of the total assets of the Guarantor and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; (ii) the Guarantor's and its other Subsidiaries' proportionate share of the total assets (after intercompany eliminations) of the Subsidiary exceeds 30 percent of the total assets of the Guarantor and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; or (iii) the Guarantor's and its other Subsidiaries' equity in the income from continuing operations before income taxes, extraordinary items and cumulative effect of a change in accounting principles of the Subsidiary exceeds 30 percent of such income of the Guarantor and its Subsidiaries consolidated as of the end of the most recently completed fiscal year.
"PRIRC" means the Puerto Rico Internal Revenue Code of 1994, as amended from time to time, and the rules and regulations promulgated thereunder from time to time.
"PROPERTY" or "PROPERTIES" means, unless otherwise specifically limited, real or personal property of any kind, tangible or intangible, choate or inchoate.
Schedule B-4
"PURCHASERS" means the Persons named as such in Schedule A of this Agreement.
"QPAM EXEMPTION" means Prohibited Transaction Class Exemption 84-14 issued by the United States Department of Labor.
"RATINGS EVENT" is defined in Section 8.
"RESPONSIBLE OFFICER" means any Senior Financial Officer and any other executive officer of the Company with responsibility for the administration of the relevant portion of this Agreement.
"SECURITIES ACT" means the Securities Act of 1933, as amended from time to time.
"SENIOR FINANCIAL OFFICER" means the chief financial officer, principal accounting officer, treasurer or comptroller of any Person.
"SIGNIFICANT SUBSIDIARY" means any Subsidiary of the Guarantor, including its Subsidiaries, which meets any of the following conditions: (i) the Guarantor's and its other Subsidiaries' investments in and advances to the Subsidiary exceed 10 percent of the total assets of the Guarantor and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; (ii) the Guarantor's and its other Subsidiaries' proportionate share of the total assets (after intercompany eliminations) of the Subsidiary exceeds 10 percent of the total assets of the Guarantor and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; or (iii) the Guarantor's and its other Subsidiaries' equity in the income from continuing operations before income taxes, extraordinary items and cumulative effect of a change in accounting principles of the Subsidiary exceeds 10 percent of such income of the Guarantor and its Subsidiaries consolidated as of the end of the most recently completed fiscal year.
"SUBSIDIARY" means with respect to any Person, any other Person more than fifty percent (50%) of whose stock or other equity interest of any class or classes having by the terms thereof ordinary voting power to elect a majority of the directors (or equivalent officials) of such other Person (irrespective of whether or not at the time stock or other equity interests of any class or classes of such other Person shall have or might have voting power by reason of the happening of any contingency) is at the time owned by such Person, directly or indirectly through Subsidiaries. Unless the context otherwise clearly requires, any reference to a "SUBSIDIARY" is a reference to a Subsidiary of the Guarantor.
"TAXABLE EVENT" means an event that causes interest paid on the Notes not to be sourced within the Commonwealth under the Code.
"TSMC" means Triple-S Management Corporation, a Puerto Rican corporation holding all the issued and outstanding shares of capital stock in the Company.
"U.S. GAAP" means generally accepted accounting principles as in effect from time to time in the United States of America.
Schedule B-5
"WHOLLY-OWNED SUBSIDIARY" means a Subsidiary of which all of the outstanding voting stock (other than directors' qualifying shares) is at the time, directly or indirectly, owned by the Guarantor, or by one or more wholly-owned Subsidiaries of the Guarantor or by the Guarantor and one or more wholly-owned Subsidiaries of the Guarantor.
Schedule B-6
TABLE OF CONTENTS
Section Page 1. AUTHORIZATION OF NOTES............................................................................................... 2 2. SALE AND PURCHASE OF NOTES........................................................................................... 2 3. CLOSING.............................................................................................................. 2 4. CONDITIONS TO CLOSING................................................................................................ 3 4.1. Representations and Warranties......................................................................... 3 4.2. Performance; No Default................................................................................ 3 4.3. Compliance Certificates................................................................................ 3 4.4. Opinions of Counsel.................................................................................... 4 4.5. Purchase Permitted by Applicable Law, etc.............................................................. 4 4.6. Private Placement Number............................................................................... 4 4.7. Changes in Corporate Structure......................................................................... 4 4.8. No Material Litigation................................................................................. 4 4.9. Proceedings and Documents; Good Standing Certificates.................................................. 5 5. REPRESENTATIONS AND WARRANTIES OF THE COMPANY AND THE GUARANTOR...................................................... 5 5.1. Organization; Power and Authority...................................................................... 5 5.2. Authorization, etc..................................................................................... 5 5.3. Financial Statements................................................................................... 6 5.4. Compliance with Laws, Other Instruments, etc........................................................... 6 5.5. Governmental Authorizations, etc....................................................................... 7 5.6. Litigation; Observance of Statutes and Orders.......................................................... 7 5.7. Taxes.................................................................................................. 7 5.8. Title to Property; Leases.............................................................................. 8 5.9. Licenses, Permits, etc................................................................................. 8 5.10. Compliance with ERISA.................................................................................. 8 5.11. Private Offering by the Company........................................................................ 9 5.12. Use of Proceeds; Margin Regulations.................................................................... 9 5.13. Existing Indebtedness for Borrowed Money............................................................... 9 5.14. Foreign Assets Control Regulations, etc................................................................ 10 5.15. Status under Certain Statutes.......................................................................... 10 5.16. Disclosure............................................................................................. 10 5.17. Changes in Condition................................................................................... 10 5.18. Subsidiaries........................................................................................... 10 5.19. Business Activity...................................................................................... 11 5.20. Source of Income....................................................................................... 11 5.21. Employee Matters....................................................................................... 11 5.22. Books and Records...................................................................................... 11 |
6. REPRESENTATIONS OF THE PURCHASER..................................................................................... 12 6.1. Purchase for Investment; Accredited Investor........................................................... 12 6.2. Source of Funds........................................................................................ 12 6.3. Anti-Money Laundering.................................................................................. 14 6.4. Transferee............................................................................................. 14 7. INFORMATION AS TO THE COMPANY AND THE GUARANTOR...................................................................... 14 7.1. Financial and Business Information..................................................................... 14 7.2. Officer's Certificate.................................................................................. 16 7.3. Inspection............................................................................................. 16 8. PAYMENT OF INTEREST.................................................................................................. 17 9. REDEMPTION OF THE NOTES PRIOR TO MATURITY............................................................................ 17 9.1. Optional Redemption.................................................................................... 17 9.2. Allocation of Partial Redemptions...................................................................... 18 9.3. Maturity; Surrender, etc............................................................................... 19 9.4. Purchase of Notes...................................................................................... 19 10. COMPANY AND GUARANTOR BUSINESS COVENANTS............................................................................. 19 10.1. Compliance with Laws; Maintenance of Licenses, etc..................................................... 19 10.2. Insurance.............................................................................................. 19 10.3. Payment of Taxes....................................................................................... 20 10.4. Use of Proceeds........................................................................................ 20 10.5. Corporate Existence, etc............................................................................... 20 10.6. Source of Income for Tax Purposes...................................................................... 21 10.7. Maintenance of Properties.............................................................................. 21 10.8. Business Activity...................................................................................... 21 11. NEGATIVE COVENANTS................................................................................................... 21 11.1. Transactions with Affiliates........................................................................... 22 11.2. Consolidation, Merger and Sale of Assets............................................................... 22 11.3. Limitation Upon Creation of Liens on Voting Stock of Principal Insurance or HMO Subsidiary............. 22 11.4. Limitation Upon Disposition of Voting Stock of Principal Insurance Subsidiary.......................... 23 12. EVENTS OF DEFAULT.................................................................................................... 24 13. REMEDIES ON DEFAULT, ETC............................................................................................. 25 13.1. Acceleration........................................................................................... 25 13.2. Other Remedies......................................................................................... 26 13.3. Rescission............................................................................................. 26 13.4. No Waivers or Election of Remedies, Expenses, etc...................................................... 26 14. REGISTRATION; EXCHANGE; SUBSTITUTION OF NOTES........................................................................ 27 14.1. Registration of Notes.................................................................................. 27 14.2. Transfer and Exchange of Notes......................................................................... 27 14.3. Replacement of Notes................................................................................... 27 |
15. PAYMENTS ON NOTES.................................................................................................... 28 15.1. Place of Payment....................................................................................... 28 15.2. Home Office Payment.................................................................................... 28 16. SURVIVAL OF REPRESENTATIONS AND WARRANTIES; ENTIRE AGREEMENT......................................................... 28 17. AMENDMENT AND WAIVER................................................................................................. 29 17.1. Requirements........................................................................................... 29 17.2. Solicitation of Holders of Notes....................................................................... 29 17.3. Binding Effect, etc.................................................................................... 30 17.4. Notes held by Company, etc............................................................................. 30 18. NOTICES.............................................................................................................. 30 19. REPRODUCTION OF DOCUMENTS............................................................................................ 31 20. CONFIDENTIAL INFORMATION............................................................................................. 31 21. MISCELLANEOUS........................................................................................................ 32 21.1. Successors and Assigns................................................................................. 32 21.2. Payments Due on Non-Business Days...................................................................... 32 21.3. Severability........................................................................................... 32 21.4. Construction........................................................................................... 33 21.5. Counterparts........................................................................................... 33 21.6. Governing Law.......................................................................................... 33 |
SCHEDULE A -- INFORMATION RELATING TO PURCHASERS
SCHEDULE B -- DEFINED TERMS
SCHEDULE 5.3(a) -- Financial Statements of the Company.
SCHEDULE 5.3(B) -- Financial Statements fo the Guarantor
SCHEDULE 5.6 -- Litigation; Observance of Statutes and Orders SCHEDULE 5.9 -- Licenses, Permits, etc. SCHEDULE 5.13 -- Existing Indebtedness for Borrowed Money SCHEDULE 5.18 -- Subsidiaries of the Guarantor EXHIBIT 1-A -- Form of 6.30% Senior Unsecured Note due September 2019 EXHIBIT 1-B -- Form of Guarantee |
EXHIBIT 2-A -- Form of Opinion of Fiddler Gonzalez & Rodriguez, P.S.C.
EXHIBIT 2-B -- Form of Opinion of Hector R. Ramos EXHIBIT 3 -- Form of Election for No Income Tax Withholding |
SCHEDULE 5.3(a) |
Financial Statements of the Company
Audited Financial Statements of Triple-S, Inc. for the years ended December 31, 2003 and 2002.
SCHEDULE 5.3(b)
Financial Statements of the Guarantor
Please refer to Appendixes A, B and C of the Private Placement Memorandum dated
September 30, 2004 for (1) the Guarantor's Non-audited Consolidated Financial
Statements for the quarters ended on March 31, 2004 and June 30, 2004, and for
(2) the Guarantor's Audited Consolidated Financial Statements for the years
ended December 31, 2003, 2002 and 2001.
SCHEDULE 5.6
Litigation
1. Jose Sanchez, et als v. Triple-S Management Corp., et al; Civil No. 2003-1967 (JAF)
2. Carlyle Benavent, Ibrahim Perez v. Comisionado de Seguros de Puerto Rico, Seguros de Servicio de Salud de Puerto Rico, Inc.; KLRA 200200234
3. Kenneth Thomas, et al. v. Blue Cross and Blue Shield Association, et al.; Civil No. 2003-21296-CIV
4. Jeffrey Solomon, et al. v. Blue Cross Blue Shield Association et al.; Civil No. 2003-22935
SCHEDULE 5.8
Title to Property; Leases
The Guarantor owns the following real estate:
1. The seven story (including the basement floor) building located at 1441 F.D. Roosevelt Avenue, in San Juan, Puerto Rico where the main office of Company and the Guarantor are located, and the adjacent two buildings, one that houses certain offices of the Company and other Subsidiaries of the Guarantor, and the adjacent parking lot.
2. Five floors of a fifteen-story building located at 1510 F.D. Roosevelt Avenue, in Guaynabo, Puerto Rico.
The aforementioned properties are subject to a mortgage in favor of FirstBank Puerto Rico ("FirstBank") as collateral to certain credit agreement by and between the Guarantor and FirstBank dated June 29, 1999 and amended on August 30, 2001.
SCHEDULE 5.9
Licenses
SCHEDULE 5.13
Existing Indebtedness for Borrowed Money
TRIPLE-S MANAGEMENT CORPORATION
AMOUNT (AS FINANCIAL INSTITUTION DESCRIPTION OF 6/30/04) --------------------- ------------ ----------- 1. First Bank Secured Loan $31,550,060 2. First Bank Secured Note $15,000,000 |
TRIPLE-S, INC.
AMOUNT (AS FINANCIAL INSTITUTION DESCRIPTION OF 6/30/04) --------------------- ---------------------- ----------- 3. Popular Securities Reverse Repo Agreement $16,200,000 4. RG Investments Reverse Repo Agreement $10,800,000 5. Banco Santander Reverse Repo Agreement $10,000,000 6. Guarantor (TSMC) Surplus Note $26,000,000 |
SCHEDULE 5.18
Subsidiaries of the Guarantor
1. Triple-S, Inc.
2. Seguros de Vida Triple-S, Inc.
3. Seguros Triple-S, Inc.
4. Triple-C, Inc.
5. Interactive Systems, Inc.
6. Smart Solutions Insurance Agency Corporation
7. Signature Insurance Agency, Inc.
EXHIBIT 1-A
THIS NOTE HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND IS NOT TRANSFERABLE EXCEPT PURSUANT TO AN EXEMPTION FROM SUCH REGISTRATION AND IN ACCORDANCE WITH THE REQUIREMENTS OF THE NOTE PURCHASE AGREEMENT REFERRED TO HEREIN.
TRIPLE-S, INC.
6.30% SENIOR UNSECURED NOTE DUE SEPTEMBER 2019
Payment of the Principal, Premium, if any, and Interest on this Note is Unconditionally Guaranteed by Triple-S Management Corporation
No. [-] September [-], 2004] US[$__________] [ ]
FOR VALUE RECEIVED, the undersigned, TRIPLE-S, INC. (herein called
the "COMPANY"), a corporation organized and existing under the laws of the
Commonwealth of Puerto Rico, hereby promises to pay to [-], or registered
assigns, the principal sum of _________ MILLION UNITED STATES DOLLARS
(US[$__________]) on September 15, 2019, with interest (computed on the basis of
a 360-day year of twelve 30-day months) (a) on the unpaid balance thereof at the
rate of six and three tenths percent (6.30%) per annum from the date hereof,
payable semiannually, on the fifteenth (15th) day of March and the fifteenth
(15th) day of September in each year, commencing on March 15, 2005, until the
principal hereof shall have become due and payable, provided that in the event
that the rating of the Notes by Standard & Poor's, falls below "BBB-" or the
rating of the Notes by A.M. Best Company, Inc. falls below "bbb-" (each a
"RATINGS EVENT"), then the interest on the unpaid balance thereof shall become
payable at the rate of seven percent (7.00%) per annum from the date of such
event; and (b) to the extent permitted by law, on any overdue payment (including
any overdue prepayment) of principal and any overdue payment of interest,
payable semiannually as aforesaid (or, at the option of the registered holder
hereof, on demand), at a rate per annum from time to time equal to the Default
Rate (as defined in the Note Purchase Agreement). The Notes will be
unconditionally guaranteed as to payment of principal, premium, if any, and
interest by TSMC as guarantor (in such capacity, the "GUARANTOR") pursuant to a
guarantee substantially in the form of Exhibit 1-B (the "GUARANTEE") to the Note
Purchase Agreement.
The Company may, at its option, upon notice as provided below,
redeem and prepay prior to maturity, all or any part of the Notes on September
15 or March 15 of each year; provided, however, that, except as provided in
Section 9.1 of the Agreement, the Company may not redeem all or any part of the
Notes pursuant to such Section 9.1 prior to September 15, 2007. On and after
September 15, 2007, the Notes shall be redeemable at a price equal to the
percentage of the principal amount of the Notes to be redeemed specified for the
periods listed below, together with accrued and unpaid interest, if any, to the
date of redemption specified by the Company (the "REDEMPTION DATE").
Redemption Periods Percentage of Principal Amount ----------------------------------- ------------------------------ September 15, 2007 - March 14, 2008 102.00% March 15, 2008 - September 14, 2008 101.50% September 15, 2008 - March 14, 2009 101.00% March 15, 2009 - September 14, 2009 100.50% September 15, 2009 and thereafter 100.00% |
The Company will give each holder of Notes written notice of any redemption under such Section 9.1 not less than sixty (60) days and not more than ninety (90) days prior to any Redemption Date.
The Company shall also have the right to redeem the Notes, at its option, in whole but not in part, at any time, within 90 days following the occurrence of a Ratings Event or, at any time, after the occurrence of a Taxable Event as provided in Section 10.6(b) of the Agreement, subject to the notice provisions set forth in the Agreement. In the case of redemption pursuant to a Ratings Event, the Company may redeem without payment of a premium. In the case of a redemption pursuant to a Taxable Event, the Company may redeem, at any time, subject to the payment of a premium pursuant to the first paragraph of such Section 9.1; provided however that if the Notes are redeemed before September 15, 2007, said redemption pursuant to a Taxable Event, is subject to the payment of a premium equal to the payment of a redemption price of 102% of the principal amount of the Notes so redeemed.
Payments of principal of and interest on with respect to this Note are to be made in lawful money of the United States of America at San Juan, Puerto Rico or at such other place in Puerto Rico as the Company shall have designated by written notice to the holder of this Note as provided in the Note Purchase Agreement referred to herein.
This Note was issued as a Senior Unsecured Note (herein called the "NOTE" or the "NOTES") pursuant to a Note Purchase Agreement dated September 30, 2004 (the "NOTE PURCHASE AGREEMENT"), between the Company, the Guarantor and the Purchasers named therein and is entitled to the benefits thereof. Each holder of this Note will be deemed, by its acceptance hereof, (i) to have agreed to the confidentiality provisions set forth in Section 20 of the Note Purchase Agreement and (ii) to have made the representations set forth in Section 6 of the Note Purchase Agreement.
This Note is registered in a register kept at the principal executive office of the Company and, as provided in the Note Purchase Agreement, upon surrender of this Note for registration of transfer, duly endorsed, or accompanied by a written instrument of transfer duly executed, by the registered holder hereof or such holder's attorney duly authorized in writing, a new Note for a like principal amount will be issued to, and registered in the name of, the transferee. Prior to due presentment for registration of transfer, the Company may treat the person in whose name this Note is registered as the owner hereof for the purpose of receiving
payment and for all other purposes, and the Company will not be affected by any notice to the contrary.
If an Event of Default, as defined in the Note Purchase Agreement, occurs and is continuing, the principal of this Note may be declared or otherwise become due and payable in the manner, at the price and with the effect provided in the Note Purchase Agreement.
This Note shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the law of the Commonwealth of Puerto Rico without regard to any principles of conflicts of law which might apply the laws of any other jurisdiction.
TRIPLE-S, INC.
By: _____________________________________________
Name: Socorro Rivas Rodriguez
Title: President and Chief Executive Officer
EXHIBIT 1-B
CORPORATE GUARANTY
OF
TRIPLE-S MANAGEMENT CORPORATION
Triple-S Management Corporation, a corporation duly organized and existing under the laws of the Commonwealth of Puerto Rico (the "Guarantor"), hereby unconditionally guarantees to the Holder of the 6.30% Senior Unsecured Note due September 2019 (the "Note") Note upon which this Guaranty is endorsed the due and punctual payment of (1) the principal of, and premium, if any, and interest on required with respect to said Note, when and as the same shall become due and payable, whether on the stated maturity date, by acceleration, redemption or repayment or otherwise, according to the terms thereof and of the Note Purchase Agreement referred to therein and (2) the payment of all other amounts by the Company and the performance of all other obligations of the Company under the Note Purchase Agreement. In case of the failure of Triple-S, Inc. (the "Company") punctually to pay any such principal, premium, or interest on the Note or such other amounts, the Guarantor hereby agrees to cause any such payment to be made punctually when and as the same shall become due and payable, whether on the stated maturity date, by acceleration, redemption or repayment or otherwise, and as if such payment were made by the Company.
The Guarantor hereby agrees that its obligations hereunder shall rank pari passu with all other senior unsecured obligations of the Guarantor whether now existing or hereafter incurred, and that such obligations shall be as principal and not merely as surety, and shall be absolute, irrevocable and unconditional, irrespective of, and shall be unaffected by, any invalidity, irregularity or unenforceability of said Note or said Note Purchase Agreement, any failure to enforce the provisions of said Note or said Note Purchase Agreement, or any waiver, modification, consent, extension of time to pay or other indulgence granted to the Company with respect thereto, by the Holder of said Note, the recovery of any judgment against the Company or any action to enforce the same, or any other circumstances which may otherwise constitute a legal or equitable discharge of a surety or guarantor. The Guarantor hereby waives diligence, presentment, demand of payment, filing of claims with a court in the event of merger, insolvency or bankruptcy of the Company, any right to require a proceeding first against the Company, protest or notice with respect to said Note or the indebtedness evidenced thereby and all demands whatsoever, and covenants that this Guaranty will not be discharged except by payment in full of the principal of, and premium, if any, and interest on required with respect to, said Note and the complete payment of all amounts payable by the Company and the performance by the Company of all other obligations contained in said Note and said Note Purchase Agreement.
The Guarantor shall be subrogated to all rights of the Holder of said Note against the Company in respect of any amounts paid to such Holder by the Guarantor pursuant to the provisions of this Guaranty; provided, however, that the Guarantor hereby irrevocably waives any and all rights to which it may be entitled, by operation of law or otherwise, upon making any payment hereunder and shall not be entitled to enforce, or to receive any payments arising out of or based upon, such right of subrogation until the principal of, and premium, if any, and interest
with respect to, all Notes issued under said Note Purchase Agreement, and all other amounts due thereunder by the Company, shall have been paid in full and its other obligations under said Note Purchase Agreement completed.
The Guarantor hereby certifies and warrants that all acts, conditions and things required to be done and performed and to have happened precedent to the creation and issuance of this Guaranty and to constitute the valid obligation of the Guarantor have been done and performed and have happened in due compliance with all applicable laws.
The Guarantor hereby represents and warrants to the Holder of the Note (which representations and warranties shall survive the delivery of this Guaranty) that:
(a) Guarantor (i) is a corporation duly organized, validly
existing and in good standing under the laws of the
Commonwealth of Puerto Rico, (ii) has full power and authority
to own its properties and assets and to carry on its business
as now being conducted and as presently contemplated, and
(iii) has full power and authority to execute, deliver and
perform its obligations under this Guaranty to which it is a
party or signatory;
(b) The execution, delivery and performance by the Guarantor of its obligations under this Guaranty will not (i) violate or conflict with (x) any provision of law, order, judgment or decree of any court or other agency or government, (y) any provision of its corporate documents, or (z) any indenture, agreement or other instrument to which the Guarantor is a party or is bound; (ii) result in a breach of, or constitute (with due notice or lapse of time or both) a default under any contractual provision to which it is bound; or (iii) result in the creation or imposition of any lien, charge or encumbrance of any nature whatsoever upon any of the property or assets of Guarantor pursuant to any indenture, agreement or instrument.
(c) The Guarantor is not required to obtain any consent, approval or authorization from or to file any declaration or statement with, any governmental instrumentality or other agency, or any other person or entity, in connection with or as a condition to the execution, delivery or performance of this Guaranty other than such as have already been obtained and are in full force and effect.
(d) There are no actions, suits or proceedings at law or in equity or by or before any governmental instrumentality or other agency, including any arbitration board or tribunal, now pending, or to the knowledge of the Guarantor, threatened (i) which is likely to affect the validity or enforceability of this Guaranty or the Guarantor's ability to perform its obligations hereunder, or (ii) against or affecting the Guarantor which, if adversely determined, individually or in the aggregate, would have a materially adverse effect on the condition (financial or otherwise), business, results of operations, prospects or properties of the Guarantor.
(e) The Guarantor is currently solvent and the Guarantor's obligations hereunder will not render the Guarantor insolvent; the Guarantor is not contemplating either a filing of a petition under any state or federal bankruptcy law, or, the liquidating of all or a major portion of its property; and the Guarantor has no knowledge of any person contemplating the filing of such petition against it.
In the event that acceleration of the time for payment of any amount payable by the Company under the Note Purchase Agreement is stayed upon the insolvency, bankruptcy or reorganization of the Company, all such amounts otherwise subject to acceleration or required to be paid upon an early termination pursuant to the terms of the Note Purchase Agreement shall nonetheless be payable by the Guarantor hereunder forthwith on demand by the Holder of the Notes.
This Guaranty shall continue to be effective or be reinstated, as the case may be, if at any time any payment of any obligation guaranteed hereunder is rescinded or must otherwise be returned by any Holder of a Note upon the insolvency, bankruptcy or reorganization of the Company, or otherwise, all as though such payment had not been made.
This Guaranty shall continue in full force and effect and be binding upon the Guarantor and the successors and permitted assigns of the Guarantor; provided, however, that the Guarantor may not assign or otherwise transfer this Guaranty or any obligations hereunder without the prior written consent of the Holder of Notes and any such assignment or transfer without such consent shall be void.
The Guarantor further agrees to pay all costs and expenses, including reasonable attorneys' fees, which may be incurred by the Holder of the Notes in any effort to collect or enforce any provision of this Guaranty.
All payments and deliveries hereunder shall be made by the Guarantor without set-off or counterclaim. The Guarantor agrees to pay any present or future stamp or documentary taxes or any other excise or property taxes, charges or similar levies which arise from any payment made hereunder or from the execution, delivery or registration of, or otherwise with respect to, this Guaranty. Without prejudice to the survival of any other agreement contained herein, the Guarantor's agreements and obligations contained in this paragraph shall survive the payment in full of the obligations and any termination of this Guaranty.
THIS GUARANTY SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE
WITH, THE LAWS OF THE COMMONWEALTH OF PUERTO RICO.
IN WITNESS WHEREOF, the Guarantor has caused this Guaranty to be duly executed by its duly authorized officer under its corporate seal.
TRIPLE-S MANAGEMENT CORPORATION
By: /s/ ----------------------------------------- Name: Ramon Ruiz Comas Title: President and Chief Executive Officer Dated: September 30, 2004 |
EXHIBIT 2-A
Form of Opinion of Fiddler Gonzalez & Rodriguez, P.S.C.
1. Each of the Company, the Guarantor, and its Subsidiaries is a corporation duly organized, validly existing and in good standing under the laws of the Commonwealth of Puerto Rico, and is in good standing in each jurisdiction in which such qualification is required by law, other than those jurisdictions as to which the failure to be so qualified or in good standing would not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect.
2. The Company has all requisite corporate power and authority to execute, deliver and perform its obligations under the Agreement and the Notes.
3. The Guarantor has all requisite corporate power and authority to execute, deliver and perform its obligations under the Agreement and the Guarantee.
4. Each of the Company and the Guarantor, and each of the other Subsidiaries of the Guarantor, has the corporate power and authority to own and operate its property, to lease the property it operates as lessee and to conduct the business in which it is currently engaged.
5. The Agreement and the Notes will be duly authorized on the Closing Date by all necessary corporate action on the part of the Company, and the Agreement constitutes, and upon execution and delivery thereof by the Company, each Note, when issued, will constitute, a legal, valid and binding obligation of the Company (assuming with respect to the Agreement and any Notes issued to the Purchaser, the due authorization, execution and delivery of the Agreement to the Purchaser), enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies (collectively, the "ENFORCEABILITY EXCEPTIONS").
6. The Agreement and the Guarantee will be duly authorized on the Closing Date by all necessary corporate action on the part of the Guarantor, and the Agreement constitutes, and upon execution and delivery thereof by the Guarantor, the Guarantee will constitute, a legal, valid and binding obligation of the Guarantor (assuming with respect to the Agreement and any Notes issued to the Purchaser, the due authorization, execution and delivery of the Agreement to the Purchaser),enforceable against the Guarantor in accordance with its terms, except to the extent that enforceability may be limited by the Enforceability Exceptions.
7. No consent, approval or authorization of, or registration, filing or declaration with, any Governmental Authority is required for the due execution, delivery or performance by the Company of the Agreement and the Notes or by the Guarantor of the Agreement and the Guarantee.
8. Neither the Company nor the Guarantor is in default under any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority or in violation of any applicable law, ordinance, rule, order or regulation of any Governmental Authority, which default or violation, individually or in the aggregate, has had, or would reasonably be expected to have a Material Adverse Effect.
9. None of the sale of the Notes by the Company hereunder, its use of the proceeds thereof or the execution and delivery of the Guarantee by the Guarantor will violate the Trading with the Enemy Act, as amended, or any of the foreign assets control regulations of the United States Treasury Department (31 CFR, Subtitle B, Chapter V, as amended) or any enabling legislation or executive order relating thereto.
10. Neither the Company nor the Guarantor is subject to regulation under the Investment Company Act of 1940, as amended, the Public Utility Holding Company Act of 1935, as amended, the Interstate Commerce Act, as amended, or the Federal Power Act, as amended.
11. Neither the Agreement nor any agreement, document, certificate or statement furnished to the Purchaser by the Company or the Guarantor in connection with the offer and sale of the Notes contains any untrue statement of material fact or, taken together with all other information furnished to the Purchaser by the Company or the Guarantor, omits to state a material fact necessary in order to make the statements contained herein or therein not misleading.
12. It is not necessary in connection with the offer, sale and delivery of the Securities to the Purchaser in the manner contemplated in the Agreement to register the Securities under the Securities Act of 1933 or the Puerto Rico Uniform Securities Act.
13. Based upon the provisions of the United States Internal Revenue Code of 1986 (the "Code"), as amended, now in force, and assuming that the Company complies with the source of income covenants contained in the note purchase agreement, then interest to be paid on the Notes will, for purposes of the Code, constitute income from sources within the Commonwealth of Puerto Rico.
EXHIBIT 2-B
Form of Opinion of Hector R. Ramos
1. Each of the Company and the Guarantor, and each of the other Subsidiaries of the Guarantor, has the corporate power and authority to own and operate its property, to lease the property it operates as lessee and to conduct the business in which it is currently engaged.
2. The Agreement and the Notes will be duly authorized on the Closing Date by all necessary corporate action on the part of the Company, and the Agreement constitutes, and upon execution and delivery thereof by the Company, each Note, when issued, will constitute, a legal, valid and binding obligation of the Company (assuming with respect to the Agreement and any Notes issued to the Purchaser, the due authorization, execution and delivery of this Agreement to the Purchaser), enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies (collectively, the "Enforceability Exceptions").
3. The Agreement and the Guarantee will be duly authorized on the Closing Date by all necessary corporate action on the part of the Guarantor, and the Agreement constitutes, and upon execution and delivery thereof by the Guarantor, the Guarantee will constitute, a legal, valid and binding obligation of the Guarantor (assuming with respect to the Agreement and any Notes issued to the Purchaser, the due authorization, execution and delivery of this Agreement by the Purchaser), enforceable against the Guarantor in accordance with its terms, except to the extent that enforceability may be limited by the Enforceability Exceptions.
4. The execution, delivery and performance by the Company of the Agreement and the Notes and by the Guarantor of the Agreement and the Guarantee, do not and will not (i) in all material respects, contravene, result in any breach of, or constitute a default under, or result in the creation of any Lien in respect of any property of the Company or the Guarantor, as applicable, under, any indenture, mortgage, deed of trust, loan, purchase or credit agreement, lease, corporate charter or by-laws, or any other Material agreement or instrument to which the Company or the Guarantor, as applicable, is bound or by which the Company or the Guarantor, as applicable, or their respective properties may be bound or affected, (ii) contravene, result in any breach of, or constitute a default under an agreement with any Governmental Authority, (iii) conflict with or result in a breach or violation of any of the terms, conditions or provisions of any order, judgment, decree, or ruling of any court, arbitrator or Governmental Authority applicable to the Guarantor or the Company, or (iv) violate any provision of any statute or other rule or regulation of any Governmental Authority applicable to the Guarantor or the Company.
5. Except as disclosed in Schedule 5.6, there are no actions, suits or proceedings pending or, to the knowledge of the Company or the Guarantor, threatened against or affecting the Company or the Guarantor or any property of the Company or the Guarantor in any court or before any arbitrator or administrative agency of any kind or before or by any Governmental Authority that, if determined adversely to the Guarantor or the Company, individually or in
the aggregate, would reasonably be expected to have a Material Adverse Effect, and no order, judgment, decree, or ruling of any court, arbitrator or Governmental Authority applicable to the Company or the Guarantor, has been issued against the Company or the Guarantor which has a Material Adverse Effect.
6. Each of the Company and the Guarantor has good and marketable title to its Material properties owned by them and reflected in the Financial Statements, as to each such property free and clear of Liens, except for those defects in title and Liens that, individually or in the aggregate, do not materially affect the value of such property and do not materially interfere with the use made and proposed to be made of such property by the Guarantor and the Company.
7. All leases of the Company and the Guarantor for real property or buildings Material in the operation of their corresponding business activities are valid and subsisting and are in full force and effect in all material respects.
8. Neither the Agreement nor any agreement, document, certificate or statement furnished to the Purchaser by the Company or the Guarantor in connection with the offer and sale of the Notes contains any untrue statement of material fact or, taken together with all other information furnished to you by the Company or the Guarantor, omits to state a material fact necessary in order to make the statements contained herein or therein not misleading.
9. Since June 30, 2004, there has been no change in the capital stock or long-term debt of the Guarantor, nor any labor dispute or court or governmental action, order or decree, or, to the knowledge of the Company or of the Guarantor, no development or event, which has had, or could reasonably be expected to have, a Material Adverse Effect.
10. All of the issued shares of capital stock of the Guarantor have been duly and validly authorized and issued, and are fully paid and non-assessable.
11. All of the issued shares of capital stock of the Company and each other Subsidiary of the Guarantor have been duly and validly authorized and issued, and are fully paid and non-assessable, and (except for directors' qualifying shares or as set forth in Schedule 5.18) are owned directly or indirectly by the Guarantor.
12. The capital stock and securities owned by the Guarantor in each of its Subsidiaries are owned free and clear of any Lien or restriction on the transfer thereon other than restrictions imposed by such Subsidiaries' respective certificates of incorporations or bylaws to the transfer of their respective capital stock or securities, applicable securities or insurance laws and restrictions and Liens outstanding on the date hereof and listed in said Schedule 5.18.
EXHIBIT 3
ELECTION FOR NO INCOME TAX WITHHOLDING
The undersigned hereby requests that no Puerto Rico income tax withholding be made on his/her/its interest payments on the Notes. The undersigned certifies that he/she/it is either:
-- Individual resident of Puerto Rico or Puerto Rico corporation electing out of the income tax withholding;
-- United States citizen not resident of Puerto Rico not subject to Puerto Rico income taxation;
-- Individual not citizen of the United States and not resident of Puerto Rico not subject to Puerto Rico income taxation;
-- Corporation or partnership organized outside Puerto Rico not engaged in trade or business in Puerto Rico not subject to Puerto Rico income taxation;
-- A tax exempt entity not subject to Puerto Rico income taxation:
___________________ (specify); or
-- Other:____________________ (specify)
Very truly yours,
By:_____________________________________
Name:
Title:*
Company: *
EXHIBIT 10.16
TRIPLE - S MANAGEMENT CORPORATION
US$60,000,000
6.60% Senior Unsecured Notes due December 2020
Dated December 15, 2005
TABLE OF CONTENTS
Section Page ----- 1. AUTHORIZATION OF NOTES.................................................................................. 1 2. SALE AND PURCHASE OF NOTES.............................................................................. 1 3. CLOSING................................................................................................. 1 4. CONDITIONS TO CLOSING................................................................................... 2 4.1. Representations and Warranties................................................................. 2 4.2. Performance; No Default........................................................................ 2 4.3. Compliance Certificates and Organizational Documents........................................... 2 4.4. Opinions of Counsel............................................................................ 3 4.5. Purchase Permitted by Applicable Law, etc...................................................... 3 4.6. Private Placement Number....................................................................... 3 4.7. Changes in Corporate Structure................................................................. 3 4.8. Proceedings and Documents...................................................................... 3 5. REPRESENTATIONS AND WARRANTIES OF THE COMPANY........................................................... 3 5.1. Organization; Power and Authority.............................................................. 3 5.2. Authorization, etc............................................................................. 4 5.3. Financial Statements........................................................................... 4 5.4. Compliance with Laws, Other Instruments, etc................................................... 5 5.5. Governmental Authorizations, etc............................................................... 5 5.6. Litigation; Observance of Statutes and Orders.................................................. 5 5.7. Taxes.......................................................................................... 6 5.8. Title to Property; Leases...................................................................... 6 5.9. Licenses, Permits, etc......................................................................... 6 5.10. Compliance with ERISA.......................................................................... 6 5.11. Private Offering by the Company................................................................ 7 5.12. Use of Proceeds................................................................................ 7 5.13. Existing Indebtedness for Borrowed Money....................................................... 7 5.14. Investment Company Act......................................................................... 8 5.15. Disclosure..................................................................................... 8 5.16. Labor Disputes................................................................................. 8 5.17. Source of Income............................................................................... 8 6. REPRESENTATIONS OF THE PURCHASER........................................................................ 8 6.1. Purchase for Investment; Accredited Investor................................................... 8 6.2. Source of Funds................................................................................ 9 6.3. Anti-Money Laundering.......................................................................... 10 6.4. Transferee..................................................................................... 11 |
7. INFORMATION AS TO THE COMPANY........................................................................... 11 7.1. Financial and Business Information............................................................. 11 7.2. Inspection..................................................................................... 12 8. PAYMENT OF INTEREST..................................................................................... 13 9. REDEMPTION OF THE NOTES PRIOR TO MATURITY............................................................... 13 9.1. Optional Redemption............................................................................ 13 9.2. Allocation of Partial Redemptions.............................................................. 13 9.3. Maturity; Surrender, etc....................................................................... 14 9.4. Purchase of Notes.............................................................................. 14 10. BUSINESS COVENANTS...................................................................................... 14 10.1. Compliance with Laws........................................................................... 14 10.2. Insurance...................................................................................... 14 10.3. Payment of Taxes............................................................................... 15 10.4. Use of Proceeds................................................................................ 15 10.5. Corporate Existence, etc....................................................................... 15 10.6. Source of Income............................................................................... 15 10.7. Lines of Business.............................................................................. 15 11. NEGATIVE COVENANTS...................................................................................... 16 11.1. Transactions with Affiliates................................................................... 16 11.2. Consolidation, Merger and Sale of Assets....................................................... 16 11.3. Limitation Upon Creation of Liens on Voting Stock of Significant Subsidiaries.................. 16 11.4. Limitation Upon Disposition of Voting Stock of, and Merger and Sale of Assets of, Principal Insurance Subsidiary................................................................. 17 11.5. Limitation on Dividends and Other Payment Restrictions Affecting Subsidiaries.................. 18 11.6. Limitation on Additional Indebtedness.......................................................... 19 11.7. Waiver of Certain Covenants.................................................................... 19 12. EVENTS OF DEFAULT....................................................................................... 19 13. REMEDIES ON DEFAULT, ETC................................................................................ 21 13.1. Acceleration................................................................................... 21 13.2. Other Remedies................................................................................. 21 13.3. Rescission..................................................................................... 21 13.4. No Waivers or Election of Remedies, Expenses, etc.............................................. 22 14. REGISTRATION; EXCHANGE; SUBSTITUTION OF NOTES........................................................... 22 14.1. Registration of Notes.......................................................................... 22 14.2. Transfer and Exchange of Notes................................................................. 22 14.3. Replacement of Notes........................................................................... 23 15. PAYMENTS ON NOTES....................................................................................... 23 15.1. Place of Payment............................................................................... 23 |
15.2. Home Office Payment............................................................................ 23 16. SURVIVAL OF REPRESENTATIONS AND WARRANTIES; ENTIRE AGREEMENT............................................ 24 17. AMENDMENT AND WAIVER.................................................................................... 24 17.1. Requirements................................................................................... 24 17.2. Solicitation of Holders of Notes............................................................... 25 17.3. Binding Effect, etc............................................................................ 25 17.4. Notes held by Company, etc..................................................................... 25 17.5. Consent of Majority Holders.................................................................... 25 18. NOTICES................................................................................................. 26 19. REPRODUCTION OF DOCUMENTS............................................................................... 26 20. CONFIDENTIAL INFORMATION................................................................................ 26 21. MISCELLANEOUS........................................................................................... 27 21.1. Successors and Assigns......................................................................... 27 21.2. Payments Due on Non-Business Days.............................................................. 28 21.3. Severability................................................................................... 28 21.4. Construction................................................................................... 28 21.5. Counterparts................................................................................... 28 21.6. Governing Law.................................................................................. 28 |
SCHEDULE A -- INFORMATION RELATING TO PURCHASER SCHEDULE B -- DEFINED TERMS SCHEDULE 5.3 -- Financial Statements of the Company SCHEDULE 5.6 -- Litigation SCHEDULE 5.13 -- Existing Indebtedness for Borrowed Money EXHIBIT 1 -- Form of 6.60% Senior Unsecured Notes due December 2020 EXHIBIT 2-A -- Form of Opinion of Pietrantoni Mendez & Alvarez LLP EXHIBIT 2-B -- Form of Opinion of Enrique R. Ubarri Baragano |
TRIPLE - S MANAGEMENT CORPORATION
6.60% Senior Unsecured Notes due December 2020
December 15, 2005
THE PURCHASERS NAMED IN
THE ATTACHED SCHEDULE A:
Ladies and Gentlemen:
Triple-S Management Corporation (the "COMPANY"), a corporation organized under the laws of the Commonwealth of Puerto Rico, agrees with you as follows:
1. AUTHORIZATION OF NOTES.
The Company has authorized the issuance and sale of an aggregate principal amount of Sixty Million United States Dollars (US$60,000,000) of its 6.60% Senior Unsecured Notes due December 2020 (the "NOTES," such term to include each Note delivered pursuant to this Agreement and each Note delivered in substitution or exchange for any such Note pursuant to Section 14 of this Agreement). The Notes shall be substantially in the form of Exhibit 1 hereto and shall have the terms as herein and therein provided. Certain capitalized terms used in this Agreement are defined in Schedule B hereto; references to a "SCHEDULE" or an "EXHIBIT" are, unless otherwise specified, to a Schedule or an Exhibit attached to this Agreement and all Schedules and Exhibits are deemed to be a part of this Agreement. References herein to this "AGREEMENT" mean this Agreement as from time to time amended or supplemented or as the terms hereof may be waived, in accordance with Section 17 hereof.
2. SALE AND PURCHASE OF NOTES.
Subject to the terms and conditions of this Agreement, the Company agrees to issue and sell to you and you agree to purchase from the Company, at the Closing provided for in Section 3, Notes in the aggregate principal amount specified opposite your name in Schedule A at the purchase price of one hundred percent (100%) of the principal amount thereof.
3. CLOSING.
The closing (the "CLOSING") of the sale and purchase of the Notes to be purchased by you shall occur at the offices of Pietrantoni Mendez & Alvarez LLP, Popular Center Building, 209 Munoz Rivera Avenue, 19th Floor, San Juan, Puerto Rico 00918, at 10:00 a.m., local time, on December 21, 2005. At the Closing, the Company will deliver to you the Notes to be purchased by you in the form of a single Note for each Purchaser (or such greater number of Notes in denominations of at least Five Hundred Thousand United States Dollars (US$500,000) as you may request) dated the date of the Closing (the "CLOSING DATE") and registered in your name (or in the name of your nominee), against delivery by you to the Company of immediately available
funds in the amount of the purchase price therefor by wire transfer to account number 10991506, maintained by the Company at Citibank, N.A., Puerto Rico Branch, ABA Number 02100089.
4. CONDITIONS TO CLOSING.
Your obligation to purchase and pay for the Notes to be delivered to you at the Closing is subject to the fulfillment, prior to or at the Closing, of the following conditions:
4.1. REPRESENTATIONS AND WARRANTIES.
The representations and warranties of the Company contained in
Section 5 of this Agreement shall have been true and correct in all material
respects as of the date of this Agreement and shall be true and correct at the
time of the Closing.
4.2. PERFORMANCE; NO DEFAULT.
The Company shall have performed and complied in all material respects with all agreements and conditions contained in this Agreement required to be performed or complied with by it prior to or at the Closing and, after giving effect to the issuance and sale of the Notes (and the application of the proceeds thereof as contemplated by Section 5.12), no Default or Event of Default shall have occurred and be continuing. The Company shall not have entered into any transaction since September 30, 2005, that would have been prohibited by Section 10 hereof had such Section applied since such date.
4.3. COMPLIANCE CERTIFICATES AND ORGANIZATIONAL DOCUMENTS.
(a) Officer's Certificate. The Company shall have delivered to you an Officer's Certificate, dated as of the Closing Date, certifying on behalf of the Company that the conditions specified in Sections 4.1, 4.2 and 4.7 have been fulfilled.
(b) Secretary's Certificates. The Company shall have delivered to you copies of the by-laws of the Company and each of its Subsidiaries (collectively, the "GROUP MEMBERS") and of the resolutions of the Board of Directors of the Company relating to the authorization, execution and delivery of the Notes, certified by the Secretary or Assistant Secretary of the Company, and an incumbency certificate executed by such Secretary or Assistant Secretary.
(c) Organizational Documents. The Company shall have delivered to you copies of the articles of incorporation of each of the Group Members, certified as of a recent date by the Secretary of State of the Commonwealth of Puerto Rico or, if a copy certified by the Secretary of State is unavailable on the Closing Date, certified by the Secretary or Assistant Secretary of each Group Member, and good standing certificates for each Group Member from such Secretary of State or, in the case of each Subsidiary that is an insurance company, from the Commissioner of Insurance of Puerto Rico.
4.4. OPINIONS OF COUNSEL.
You shall have received opinions from (a) Pietrantoni Mendez & Alvarez LLP, special counsel to the Company, and (b) Enrique R. Ubarri Baragano, Senior Vice President, Legal Affairs, of the Company, each dated as of the Closing Date, substantially in the respective forms set forth as Exhibits 2-A and 2-B. This Section 4.4 shall constitute direction by the Company to such counsel named in the foregoing clauses (a) and (b) to deliver the opinions specified to you at the Closing.
4.5. PURCHASE PERMITTED BY APPLICABLE LAW, ETC.
On the Closing Date, your purchase of Notes shall (i) be permitted by the laws and regulations of each jurisdiction to which you are subject, without recourse to provisions of law permitting limited investments by financial institutions without restriction as to the character of the particular investment, (ii) not violate any applicable law or regulation and (iii) not subject you to any tax, penalty or liability under or pursuant to any applicable law or regulation, which law or regulation was not in effect on the date hereof.
4.6. PRIVATE PLACEMENT NUMBER.
A Private Placement number issued by Standard & Poor's CUSIP Service Bureau shall have been obtained for the Notes.
4.7. CHANGES IN CORPORATE STRUCTURE.
The Company shall not have changed its jurisdiction of incorporation or been a party to any merger or consolidation. The Company shall not have succeeded to all or any substantial part of the liabilities of any other entity following the date of the most recent financial statements referred to in Schedule 5.3.
4.8. PROCEEDINGS AND DOCUMENTS.
All corporate and other proceedings in connection with the transactions contemplated by this Agreement and all documents and instruments incident to such transactions shall be reasonably satisfactory to you and your counsel, and you and your counsel shall have received all such counterpart originals or certified or other copies of such documents as you or they may reasonably request.
5. REPRESENTATIONS AND WARRANTIES OF THE COMPANY.
The Company represents and warrants to you as follows:
5.1. ORGANIZATION; POWER AND AUTHORITY.
Each Group Member is a corporation duly organized, validly existing and in good standing under the laws of the Commonwealth of Puerto Rico, and is duly qualified as a foreign corporation and is in good standing in each jurisdiction in which such qualification is required by law, other than those jurisdictions as to which the failure to be so qualified or in good standing
would not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect. The Company and each Subsidiary has the corporate power and authority to conduct its business as presently conducted and as proposed to be conducted after the Acquisition. The Company has the corporate power and authority to execute and deliver this Agreement and the Notes and to perform the provisions hereof and thereof.
5.2. AUTHORIZATION, ETC.
This Agreement has been, and on the Closing Date the Notes will be, duly authorized by all necessary corporate action on the part of the Company, and this Agreement constitutes, and upon execution and delivery thereof by the Company each Note issued to you will constitute, a legal, valid and binding obligation of the Company (assuming with respect to this Agreement and any Notes issued to you, the due authorization, execution and delivery of this Agreement by you), enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies.
5.3. FINANCIAL STATEMENTS.
(a) The Company has delivered to you copies of the financial statements of the Company listed on Schedule 5.3 (such financial statements collectively the "FINANCIAL STATEMENTS").
(b) The Financial Statements (including in each case the related schedules and notes) fairly present in all material respects the consolidated financial position of the Company and its Subsidiaries as of the respective dates specified in such Financial Statements and the consolidated results of its operations and cash flows for the respective periods so specified in accordance with GAAP consistently applied throughout such periods except as set forth in the notes thereto (subject, in the case of any interim financial statements, to normal year-end adjustments).
(c) Since the date of the most recent Financial Statement, there has been no material adverse change in the business, operations or condition (financial or otherwise) of the Company and its Subsidiaries taken as a whole, and no event that could reasonably be expected to have a Material Adverse Effect, and the Company has not incurred any material Indebtedness for Borrowed Money or entered into any material transaction other than as disclosed to the Purchasers.
(d) The Company maintains a system of internal accounting controls sufficient to provide reasonable assurance that (i) transactions are executed in accordance with management's general or specific authorization, (ii) transactions are recorded as necessary to permit preparation of financial statements in conformity with GAAP and to
maintain accountability for assets, (iii) access to assets is permitted only in accordance with management's general or specific authorization, and (iv) the recorded accountability for assets is compared with existing assets at reasonable intervals and appropriate action is taken with respect to any differences.
5.4. COMPLIANCE WITH LAWS, OTHER INSTRUMENTS, ETC.
The execution, delivery and performance by the Company of this Agreement and the Notes will not (i) in any material respect contravene, result in any breach of, or constitute a default under, or result in the creation of any Lien in respect of any property of the Company or any of its Significant Subsidiaries under, any indenture, mortgage, deed of trust, loan, purchase or credit agreement, lease, corporate charter or by-laws, or any other material agreement or instrument to which the Company or any such Significant Subsidiary is bound or by which the Company or any such Significant Subsidiary or their respective properties may be bound or affected, (ii) conflict with or result in a material breach of any of the terms, conditions or provisions of any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority applicable to the Company or any of its Significant Subsidiaries, or (iii) violate any provision of any statute or other rule or regulation of any Governmental Authority applicable to the Company or any of its Significant Subsidiaries.
5.5. GOVERNMENTAL AUTHORIZATIONS, ETC.
No consent, approval or authorization of, or registration, filing or declaration with, any Governmental Authority is required for the due execution, delivery or performance by the Company of this Agreement or the Notes.
5.6. LITIGATION; OBSERVANCE OF STATUTES AND ORDERS.
(a) Except as disclosed in Schedule 5.6, there are no actions, suits or proceedings pending or, to the knowledge of the Company, threatened against or affecting the Company or any of its Significant Subsidiaries or any property of the Company or of its Significant Subsidiaries in any court or before any arbitrator or administrative agency of any kind or before or by any Governmental Authority that, if determined adversely to the Company or any of its Significant Subsidiaries, individually or in the aggregate, would reasonably be expected to have a Material Adverse Effect.
(b) Neither the Company nor any of its Significant Subsidiaries is in default under any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority or in violation of any applicable law, ordinance, rule or regulation of any Governmental Authority, which default or violation, individually or in the aggregate, would reasonably be expected to have a Material Adverse Effect.
5.7. TAXES.
Each of the Company and its Significant Subsidiaries has filed all income tax returns that are required to have been filed, except for any filings which failure to make would not be reasonably expected to have a Material Adverse Effect, and has paid all taxes shown to be due and payable on such returns and all other taxes payable by it, to the extent such taxes have become due and payable, except for any taxes (i) the amount of which would not individually or in the aggregate reasonably be expected to have a Material Adverse Effect or (ii) the amount, applicability or validity of which is currently being contested in good faith by appropriate proceedings and with respect to which the Company and each such Significant Subsidiary has established adequate reserves in accordance with GAAP. The Company is not aware of any tax deficiency that, if determined adversely to the Company or any Significant Subsidiary, could reasonably be expected to result in a Material Adverse Effect.
5.8. TITLE TO PROPERTY; LEASES.
Each of the Company and its Significant Subsidiaries has good and sufficient title to its respective material properties, free and clear of Liens, except for (i) Liens described in Schedule 5.8, and (ii) defects in title that, individually or in the aggregate, would not have a Material Adverse Effect. All material leases entered into by the Company and its Significant Subsidiaries are valid and subsisting and are in full force and effect in all material respects.
5.9. LICENSES, PERMITS, ETC.
The Company and each of its Significant Subsidiaries owns or possesses all licenses, permits, franchises, authorizations, patents, copyrights, service marks, trademarks and trade names, or rights thereto, that are material to its business, without known conflict with the rights of others, except for those conflicts that, individually or in the aggregate, would not have a Material Adverse Effect.
5.10. COMPLIANCE WITH ERISA.
(a) Each of the Company, its Significant Subsidiaries and each of their respective ERISA Affiliates has operated and administered each Plan in compliance in all material respects with all applicable laws except for such instances of noncompliance as have not resulted in and would not reasonably be expected to result in a Material Adverse Effect. None of the Company, its Significant Subsidiaries nor their respective ERISA Affiliates has incurred any liability pursuant to Title I or IV of ERISA or applicable penalty or excise tax provisions of the PRIRC relating to employee benefit plans (as defined in section 3 of ERISA), and no event, transaction or condition has occurred or exists that would reasonably be expected to result in the incurrence of any such liability by the Company, its Significant Subsidiaries or any of such ERISA Affiliates, or in the imposition of any Lien on any of the rights, properties or assets of the Company, its Significant Subsidiaries or any of such ERISA Affiliates, in either case pursuant to Title I or IV of ERISA or to such penalty or excise
tax provisions of the PRIRC, other than in any of such cases, such liabilities or Liens as would not reasonably be expected to result, individually or in the aggregate, in a Material Adverse Effect.
(b) None of the Company, its Significant Subsidiaries nor their respective ERISA Affiliates has incurred withdrawal liabilities (or is subject to contingent withdrawal liabilities) under section 4201 or 4204 of ERISA in respect of Multiemployer Plans that individually or in the aggregate would reasonably be expected to result in a Material Adverse Effect.
(c) The execution and delivery of this Agreement and the issuance
and sale of the Notes hereunder will not involve any
transaction that is subject to the prohibitions of section 406
of ERISA or in connection with which a tax could be imposed
pursuant to the PRIRC. The representation by the Company in
the first sentence of this Section 5.10(c) is made in reliance
upon and subject to (i) the accuracy of your representation in
Section 6.2 as to the sources of the funds to be used to pay
the purchase price of the Notes to be purchased by you and
(ii) the assumption, made solely for the purpose of making
such representation, that Department of Labor Interpretive
Bulletin 75-2 with respect to prohibited transactions remains
valid in the circumstances of the transactions contemplated
herein.
5.11. PRIVATE OFFERING BY THE COMPANY.
Neither the Company nor UBS Financial Services Incorporated of Puerto Rico, as placement agent (the only Person authorized or employed by the Company as agent, broker, dealer or finder in connection with the offering or sale of the Notes) has offered any of the Notes or any similar securities for sale to, or solicited any offer to buy any of the same from, or otherwise approached or negotiated in respect thereof with, any Person other than you. As used in the preceding sentence, "SIMILAR SECURITY" means a security which would be integrated with the offering of the Notes under applicable securities laws. Neither the Company nor such agent has taken, or will take, any action that would subject the issuance or sale of the Notes to the registration requirements of Section 5 of the Securities Act.
5.12. USE OF PROCEEDS.
The Company will apply the proceeds from the sale of the Notes for working capital and general corporate purposes, which may include the purchase of evidences of indebtedness issued by Puerto Rico corporations (including indebtedness evidenced under surplus notes issued by its Subsidiaries).
5.13. EXISTING INDEBTEDNESS FOR BORROWED MONEY.
Schedule 5.13 sets forth a complete and correct list of all outstanding Indebtedness for Borrowed Money in the principal amount of at least Five Million United States Dollars (US$5,000,000) of the Company and its Significant Subsidiaries as of September 30, 2005, since which date there has been no material change in the amounts, interest rates, sinking funds, installment payments or maturities of such Indebtedness for Borrowed Money. Neither
the Company nor any of its Significant Subsidiaries is in default (and no waiver of any such default is currently in effect) in the payment of any principal or interest on, and no Event of Default exists with respect to, any such Indebtedness for Borrowed Money.
5.14. INVESTMENT COMPANY ACT.
The Company is not subject to regulation under the Investment Company Act of 1940, as amended.
5.15. DISCLOSURE.
No statement or information contained in this Agreement or any other document, certificate or statement furnished to the Purchasers or any of them, by or on behalf of the Company in connection with the transactions contemplated by this Agreement contained as of the date such statement, information, document or certificate was so furnished any untrue statement of a material fact or omitted to state a material fact necessary in order to make the statements contained herein or therein in the light of the circumstances in which they were made not misleading. The projections and pro forma financial information contained in the materials referenced above are based upon good faith estimates and assumptions believed by management of the Company to be reasonable at the time made, it being recognized by the Purchasers that such financial information as it relates to future events is not to be viewed as fact and that actual results during the period or periods covered by such financial information may differ from the projected results set forth therein by a material amount.
5.16. LABOR DISPUTES.
None of the Company nor its Significant Subsidiaries is engaged in any labor dispute that could reasonably be expected to have a Material Adverse Effect.
5.17. SOURCE OF INCOME.
The Company has derived more than 20 percent of its gross income from Commonwealth of Puerto Rico sources on an annual basis since its incorporation in accordance with the applicable sourcing rules under the Code.
6. REPRESENTATIONS OF THE PURCHASER.
You hereby represent and warrant to the Company as follows:
6.1. PURCHASE FOR INVESTMENT; ACCREDITED INVESTOR.
(a) You are purchasing the Notes for your own account and not with a view to, or for sale in connection with, the distribution thereof within the meaning of the Securities Act, provided that you have the right to dispose of the Notes, or any part thereof, if you deem it advisable to do so, either pursuant to a registration of the Notes under the Securities Act or pursuant to an applicable exemption from the registration requirements of the
Securities Act. You understand that the Notes have not been registered under the Securities Act or the Puerto Rico Uniform Securities Act, as amended ("PRUSA"), and you understand and agree that the Notes may be resold only if registered pursuant to the provisions of the Securities Act or if an exemption from registration is available thereunder.
(b) You are an "ACCREDITED INVESTOR" as defined in Rule 501(a) under the Securities Act.
(c) It is understood that, in making the representations set out in Sections 5.4, 5.5 and 5.10 hereof, the Company is relying, to the extent applicable, upon your representations set forth in this Section 6.1.
(d) (i) You have consulted with your own legal and tax advisers in
connection herewith to the extent you have deemed necessary,
(ii) you have had a reasonable opportunity to ask questions of
and receive answers from officers and representatives of the
Company and its Subsidiaries concerning their respective
financial condition and results of operations and any other
matter relevant to the purchase of the Notes, and any such
questions have been answered to your satisfaction, (iii) you
have had the opportunity to review all publicly available
records and filings concerning the Company and its
Subsidiaries, and (d) you have made your own investment
decisions based upon your own judgment, due diligence and
advice from such advisers as you have deemed necessary and
upon the representations made by the Company herein.
6.2. SOURCE OF FUNDS.
At least one of the following statements is an accurate representation as to each source of funds (a "SOURCE") to be used by you to pay the purchase price of the Notes to be purchased by you hereunder:
(a) all or part of the Source constitutes assets of a bank collective investment fund, as contemplated by PTE 91-38, maintained by you, and you have disclosed to the Company the names of such employee benefit plans whose assets in such bank collective investment fund exceed ten percent of the total assets or are expected to exceed ten percent of the total assets of such fund as of the date of such purchase (for the purpose of this clause (a), all employee benefit plans maintained by the same employer or employee organization are deemed to be a single plan);
(b) all or part of the Source constitutes assets of one or more employee benefit plans, each of which has been identified to the Company in writing;
(c) you are acquiring the Notes for the account of one or more pension funds, trust funds or agency accounts, each of which is a "GOVERNMENTAL PLAN" (as defined in section 3(32) of ERISA) and the investment does not give rise to any violation of any federal, state or local law which is substantially
similar to Title I of ERISA, section 4975 of the Code or comparable provisions of the PRIRC;
(d) the Source is an "INVESTMENT FUND" managed by a "QUALIFIED PROFESSIONAL ASSET MANAGER" or "QPAM" (as defined in Part V of PTE 84-14, issued March 13, 1984), provided that (i) no other party to the transaction described in this Agreement and no "AFFILIATE" of such party (as defined in Part V(c) of PTE 84-14) has at this time, and during the immediately preceding one year none has exercised, the authority to appoint or terminate said QPAM as manager of the assets of any plan identified in writing pursuant to this clause (d) or to negotiate the terms of said QPAM's management agreement on behalf of any such identified plans, (ii) the conditions set forth in paragraphs (c), (d), (e), (f) and (g) of Part I of PTE 84-14 are satisfied; and (iii) you have disclosed to the Company the name of the QPAM and of all employee benefit plans whose assets are included in such investment fund;
(e) the Source is a "PLAN" managed by an "IN-HOUSE ASSET MANAGER" or "INHAM" (as defined in Part IV of PTE 96-23, issued April 10, 1996), provided that the conditions set forth in paragraphs (a), (c), (d), (e), (f), (g) and (h) of Part I of PTE 96-23 are satisfied; or
(f) none of such funds consists of assets of any "EMPLOYEE BENEFIT PLAN" as defined in ERISA or any "PLAN" as defined in section 4975 of the Code or comparable provisions of the PRIRC, other than an employee benefit plan or plan exempt from the coverage of ERISA and section 4975 of the Code.
As used in this Section 6.2, the terms "EMPLOYEE BENEFIT PLAN," "GOVERNMENTAL PLAN," "PARTY IN INTEREST" and "SEPARATE ACCOUNT" shall have the respective meanings assigned to such terms in section 3 of ERISA. If you breach any representation made by you under this Section 6.2, your purchase of the Notes shall be void ab initio.
6.3. ANTI-MONEY LAUNDERING.
(a) The funds that you are using to purchase the Notes were not directly or indirectly derived from activities that may contravene federal, state and international laws and regulations, including Anti-Money Laundering Laws; and
(b) to the best of your knowledge, neither:
(i) you, nor
(ii) any person controlling, controlled by, or under common control with you,
(1) is a country, territory, individual or entity named on an Office of Foreign Assets Control ("OFAC") list, or is an individual or entity that resides or has a
place of business in a country or territory named on such lists, (2) is a "senior foreign political figure," or any "immediate family member" or "close associate" (as such terms are defined in the Patriot Act) of a senior foreign political figure or (3) is a "foreign shell bank" (as defined in the Patriot Act) or transacts business with a foreign shell bank.
You understand that the Company may not accept any payments for the Notes from you if you cannot make the representations set forth above.
6.4. TRANSFEREE.
Any transferee of a Note shall, by its acceptance of such Note, be deemed to have made the same representations regarding the purchase of the Notes as the original holder thereof made pursuant to Sections 6.1, 6.2 and 6.3 above.
7. INFORMATION AS TO THE COMPANY.
7.1. FINANCIAL AND BUSINESS INFORMATION.
The Company shall deliver to you and to any subsequent holder of Notes that is an Institutional Investor, subject to the proviso contained at the end of Section 7.2 hereof:
(a) SEC and Other Reports -- for so long as the Company is subject
to reporting obligations under the Securities Exchange Act of
1934, as amended (the "EXCHANGE ACT") with respect to any of
its securities, within ten (10) days after it files them with
the U.S. Securities and Exchange Commission (the "SEC"), one
copy of its annual report and of the information, documents
and other reports which the Company is required to file with
the SEC pursuant to Section 13 or 15(d) of the Exchange Act;
provided that no such delivery shall be required as to any of
such reports and documents which have been filed and are
available in electronic format at the SEC's EDGAR database. In
the event that the Company is at any time no longer subject to
the reporting requirements of Section 13 or 15(d) the Exchange
Act, the Company shall provide to you and each subsequent note
holder that is an Institutional Investor, (1)(i) within sixty
(60) days after the end of each of the first three quarterly
fiscal periods in each fiscal year of the Company: an
unaudited consolidated balance sheet of the Company as at the
end of such quarter, and the related unaudited consolidated
statements of income and cash flows of the Company for such
quarter; and (ii) within one hundred twenty (120) days after
the end of each fiscal year of the Company, the consolidated
audited balance sheet of the Company and the related
consolidated statements of income and cash flows of the
Company for such year; and (2) at your request, (i) a
quarterly presentation which shall include a discussion by the
Company's management of the most recent financial and
operational results of the Company and its Significant
Subsidiaries on a consolidated basis and a discussion of the
Company's
most recent business plans and projections, and (ii) on a yearly basis, a written report reflecting a discussion by the Company's management of the financial and operational results of the Company and its Significant Subsidiaries on a consolidated basis as of the year ended. In addition, on a quarterly basis, the Company's designated legal counsel, at your request, will provide you and your designated legal counsel, access to material and recent information so as to provide an update to the status of all material legal actions, suits or proceedings;
(b) Notice of Default or Event of Default -- within ten (10) days after a Responsible Officer becomes aware of the existence of any condition or event which constitutes a Default or Event of Default, a written notice specifying the nature thereof and what action the Company is taking or proposes to take with respect thereto;
(c) Compliance Certificate -- concurrently with the delivery of any financial statements pursuant to Section 7.1(a), a certificate of a Responsible Officer stating that, to the best of such Responsible Officer's knowledge, the Company and each Subsidiary during such period has observed or performed all of its covenants and other agreements, and satisfied every condition, contained in this Agreement, and that such Responsible Officer has obtained no knowledge of any Default or Event of Default except as specified in such certificate; and
(d) Notice of Reduction in Risk-based Capital Ratio -- within fifteen (15) days after the end of any month in which the Company's Risk-based Capital Ratio shall be lower than 375%, a written notice specifying the Company's Risk-based Capital Ratio as of the end of such month and what action the Company is taking or proposes to take with respect thereto.
7.2. INSPECTION.
The Company shall permit each holder of Notes that is an Institutional Investor, or a group of Institutional Investors that are (i) Puerto Rico licensed investment companies advised by the same investment adviser and (ii) Purchasers and holders of Notes, and holds Notes with an aggregate principal amount of at least Ten Million United States Dollars (US$10,000,000), or at least Five Million United States Dollars (US$5,000,000) in the case of such group, together with their respective representatives, at the expense of the Company if done in connection with an Event of Default, to visit and inspect any of the offices or properties of the Company and its Significant Subsidiaries to examine their books and records, and to discuss their affairs, finances and accounts with their officers, employees and independent public accountants (and by this provision, the Company authorizes said accountants to discuss the finances and affairs of the Company and its Significant Subsidiaries, but any such discussions shall be arranged by the Company and the Company shall have the opportunity to participate therein) all at such reasonable times and as may be reasonably requested in relation to the performance by the Company of its obligations under the Notes or under this Agreement;
provided, however, that the Company (or any such Significant Subsidiary) shall not be required to disclose to any such holder of Notes (or to any of its representatives) information to the extent that the Company (or any such Significant Subsidiary) is advised by internal or external legal counsel that it is prohibited from disclosing such information at such time to its creditors generally under applicable laws, rules, regulations or orders (or other binding restrictions imposed by Governmental Authorities or agreements entered into in good faith with third parties that are not Affiliates of the Company).
8. PAYMENT OF INTEREST.
The Company shall pay interest (computed on the basis of a 360-day year of twelve 30-day months) (a) on the unpaid balance of the Notes at the rate of 6.60% per annum from the date of the Notes, payable monthly in arrears, on the first (1st) day of each month, commencing on January 1, 2006, until the principal of the Notes shall have become due and payable and (b) to the extent permitted by law, on any overdue payment (including any overdue prepayment) of principal and any overdue payment of interest, payable monthly as aforesaid (or, at the option of the registered holder hereof, on demand), at a rate per annum from time to time equal to the Default Rate. Notwithstanding the above, in the event that the Company's Risk-based Capital Ratio is less than 375% during a period of at least one year, the interest rate payable on the Notes on any interest payment date after the expiration of such year shall increase to 6.75% per annum while such condition exists. The interest so payable on any interest payment date will be paid to the Holder in whose name a Note is registered at the close of business on the fifteenth (15th) calendar day (whether or not a Business Day) next preceding such interest payment date.
9. REDEMPTION OF THE NOTES PRIOR TO MATURITY.
9.1. OPTIONAL REDEMPTION.
The Company may, at its option, upon notice as provided below, redeem and prepay prior to maturity from time to time, all or any part of the Notes on or after January 1, 2011, at a price equal to 100% of the principal amount of the Notes to be redeemed together with accrued and unpaid interest, if any, to the date of redemption specified by the Company (the "REDEMPTION DATE").
The Company will give each holder of Notes written notice of any redemption under this Section 9.1 not less than thirty (30) days and not more than sixty (60) days prior to any Redemption Date. Each such notice shall specify the Redemption Date, the aggregate principal amount of the Notes to be redeemed on such Redemption Date, the principal amount of each Note held by such holder to be redeemed (determined in accordance with Section 9.2), and the interest to be paid on such Redemption Date with respect to such principal amount being redeemed.
9.2. ALLOCATION OF PARTIAL REDEMPTIONS.
In the case of any partial redemption of the Notes, the principal amount of the Notes to be redeemed shall be allocated among all of the Notes at the time outstanding in
proportion, as nearly as practicable, to the respective unpaid principal amounts thereof not theretofore called for redemption.
9.3. MATURITY; SURRENDER, ETC.
In the case of each redemption of Notes pursuant to this Section 9, the principal amount of each Note to be redeemed shall mature and become due and payable on the respective Redemption Date, together with interest on such principal amount accrued to such date. From and after such date, unless the Company shall fail to pay such principal amount when so due and payable, together with the interest thereon, interest on such principal amount shall cease to accrue. Any Note paid or redeemed in full shall be surrendered to the Company and cancelled and shall not be reissued, and no Note shall be issued in lieu of any prepaid principal amount of any Note.
9.4. PURCHASE OF NOTES.
The Company will not, and the Company will not permit any of its Affiliates to, purchase, redeem, prepay or otherwise acquire, directly or indirectly, any of the outstanding Notes except (i) pursuant to an offer made to all holders of the Notes or (ii) upon the payment or redemption of the Notes in accordance with the terms of this Agreement and the Notes. The Company will promptly cancel all Notes acquired by it or any of its Affiliates pursuant to any payment, redemption or purchase of Notes pursuant to any provision of this Agreement and no Notes may be issued in substitution or exchange for any such Notes.
10. BUSINESS COVENANTS.
The Company covenants that, so long as the Notes are outstanding, it will, and it will cause each of its Significant Subsidiaries to:
10.1. COMPLIANCE WITH LAWS.
Comply with all laws, ordinances and governmental rules and regulations to which it is subject and obtain and maintain in effect all licenses, certificates, permits, franchises and other governmental authorizations necessary to the ownership of its properties or to the conduct of its businesses, in each case to the extent necessary to ensure that non-compliance with such laws, ordinances or governmental rules or regulations or failures to obtain or maintain in effect such licenses, certificates, permits, franchises and other governmental authorizations would not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect.
10.2. INSURANCE.
Except where the failure to comply would not reasonably be expected to have a Material Adverse Effect, maintain, with financially sound and reputable insurers, insurance with respect to its properties and business against such casualties and contingencies, of such types, on such terms and in such amounts (including deductibles, co-insurance and self-insurance, if adequate reserves are maintained with respect thereto) as is customary in the case of entities of established reputations engaged in the same or a similar business and similarly situated.
10.3. PAYMENT OF TAXES.
File all tax returns required to be filed and pay and discharge or cause to be paid or discharged all taxes shown to be due and payable on such returns and all other taxes and assessments payable by it, to the extent such taxes and assessments have become due and payable, provided that the Company or such Significant Subsidiary need not (a) make any filing the failure to make which would not be reasonably expected to have a Material Adverse Effect or (b) pay any such tax or assessment if (i) the amount, applicability or validity thereof is contested by the Company or such Significant Subsidiary on a timely basis in good faith and in appropriate proceedings, and the Company or such Significant Subsidiary has established adequate reserves therefor in accordance with GAAP on their respective books, or (ii) the nonpayment of all such taxes and assessments in the aggregate would not reasonably be expected to have a Material Adverse Effect.
10.4. USE OF PROCEEDS.
Apply the proceeds from the sale of the Notes for the purposes set forth in Section 5.12 hereof within twenty-four (24) months from the date of the issuance of the Notes. The Company will notify Treasury of such use as required by Section 1013A of the PRIRC.
If a favorable ruling from Treasury is obtained after the Closing Date, by purchasing the Notes, the subsequent holders of the Notes, other than the Purchasers, will be deemed to have made an election under Section 1013A of the PRIRC and the 10 percent preferential withholding tax will be made on the interest on the Notes unless such holders elect out of such withholding by providing a written statement to that effect to the Company, through certified mail, in the form set forth in Exhibit 3.
10.5. CORPORATE EXISTENCE, ETC.
Subject to the provisions of Sections 11.2 and 11.4 hereof, the Company will do or cause to be done all things necessary to preserve and keep in full force and effect the corporate existence, rights (charter and statutory) and franchises of the Company and each Significant Subsidiary; provided, however, that the Company shall not be required to preserve any such right or franchise or corporate existence of a Significant Subsidiary if the Company shall determine that the preservation thereof is no longer desirable in the conduct of the business of the Company and that the loss thereof is not disadvantageous in any material respect to the holders of the Notes.
10.6. SOURCE OF INCOME.
The Company shall do or cause to be done all things necessary or proper within its control to ensure that, for purposes of the Code, interest paid on the Notes will constitute income from sources within the Commonwealth of Puerto Rico.
10.7. LINES OF BUSINESS.
The Company will continue to be a Blue Cross/Blue Shield licensee and will be principally engaged in the business of providing health, life and property and casualty insurance.
11. NEGATIVE COVENANTS.
The Company covenants that, so long as any of the Notes is outstanding, it will not:
11.1. TRANSACTIONS WITH AFFILIATES.
Enter into, or permit any of its Significant Subsidiaries to enter into, directly or indirectly, into any transaction or group of related transactions which, in the opinion of the management of the Company, is material to the Company and its Subsidiaries taken as a whole (including without limitation the purchase, lease, sale or exchange of properties of any kind or the rendering of any service) with any of its Affiliates, except (i) pursuant to its reasonable business requirements and (ii) in the case of transactions with Affiliates other than wholly owned Subsidiaries, on arm's length terms.
11.2. CONSOLIDATION, MERGER AND SALE OF ASSETS.
Not consolidate with or merge into, or convey, transfer or lease its properties and assets substantially as a whole to,
any Person, unless:
(a) the Company is the surviving or continuing entity, or the entity formed by such consolidation or into which the Company is merged or to which the Company has conveyed, transferred or leased its properties and assets substantially as an entirety is an entity organized and validly existing under the laws of the United States of America, any province or state thereof or the District of Columbia or the Commonwealth of Puerto Rico, and such entity expressly assumes the Company's obligations under the Notes by an agreement supplemental hereto;
(b) immediately after giving effect to the transaction, no Default shall have occurred and be continuing; and
(c) the Company shall have delivered to each holder an Officer's Certificate and an opinion of counsel, each stating that such consolidation, merger or transfer and such supplemental agreement (if any) comply with this Agreement.
Notwithstanding the provisions of this Section 11.2, any wholly owned Subsidiary may merge or consolidate with the Company or another wholly owned Subsidiary so long as the Company or such wholly owned Subsidiary shall be the surviving or continuing corporation.
11.3. LIMITATION UPON CREATION OF LIENS ON VOTING STOCK OF SIGNIFICANT SUBSIDIARIES.
Incur, issue, assume or guarantee, nor permit any Significant Subsidiary to incur, issue, assume or guarantee, any Indebtedness for Borrowed Money, directly or indirectly secured by a Lien in any shares of voting stock of any Significant Subsidiary without making effective provision whereby the Notes (and, if the Company so elects, any other indebtedness of the Company ranking on a parity with the Notes) shall be secured equally and ratably with such
secured indebtedness; provided, however, that the foregoing covenant shall not
apply to (i) any Lien in any shares of voting stock of any corporation existing
at the time such corporation becomes a Significant Subsidiary; (ii) Liens for
taxes or assessments or governmental charges (a) not then due and delinquent or
(b) the validity of which is being contested in good faith or (c) which are less
than Five Million United States Dollars (US$5,000,000) in amount; (iii) Liens
(other than consensual Liens) created or resulting from any litigation or legal
proceeding (a) which is currently being contested in good faith by appropriate
proceedings, (b) which involves claims of less than Five Million United States
Dollars (US$5,000,000), or (iv) deposits to secure (or in lieu of) surety, stay,
appeal or custom bonds.
If the Company shall hereafter be required to secure the Notes
equally and ratably with any other indebtedness of the Company pursuant to this
Section 11.3 hereof, the Company shall promptly deliver to the holders an
Officer's Certificate stating that the foregoing covenant has been complied
with, and an opinion of counsel stating that in the opinion of such counsel the
foregoing covenant has been complied with and that any instruments executed by
the Company or any Subsidiary in the performance of the foregoing covenant
comply with the requirements of the foregoing covenant.
11.4. LIMITATION UPON DISPOSITION OF VOTING STOCK OF, AND MERGER AND SALE OF ASSETS OF, PRINCIPAL INSURANCE SUBSIDIARY.
Subject to the provisions of Section 11.2 hereof, (i) sell, assign, transfer or otherwise dispose of any shares of, securities convertible into or options, warrants or rights to subscribe for or purchase shares of, voting stock (other than directors' qualifying shares) of its Principal Insurance Subsidiary or permit its Principal Insurance Subsidiary to issue (except to the Company) any shares of, securities convertible into or options, warrants or rights to subscribe for or purchase shares of, voting stock of the Principal Insurance Subsidiary, except for sales, assignments, transfers or other dispositions that:
(a) are for fair market value on the date thereof, as determined by the Board of Directors of the Company (which determination shall be conclusive) and, after giving effect to such disposition and to any possible dilution, the Company will own (directly or indirectly) not less than 80% of the shares of voting stock of its Principal Insurance Subsidiary then issued and outstanding free and clear of any Lien;
(b) are made in compliance with an order of a court or regulatory authority of competent jurisdiction, as a condition imposed by any such court or authority permitting the acquisition by the Company, directly or indirectly, of any other insurance company or health maintenance organization or entity the activities of which are legally permissible for a holding company of such entities or a subsidiary thereof to engage in, or as an undertaking made to such authority in connection with such an acquisition, which entity agrees to be bound by this covenant as the Principal Insurance Subsidiary; or
(c) are made after such Principal Insurance Subsidiary, having obtained any necessary regulatory approvals, unconditionally guarantees payment when due of the principal of and premium, if any, and interest on the Notes and agrees to comply with the restrictions that are applicable to it hereunder; or
(d) are made to the Company or any wholly owned Subsidiary if such wholly owned Subsidiary agrees to be bound by this covenant as the Principal Insurance Subsidiary and the Company agrees to maintain such wholly owned Subsidiary as a wholly owned Subsidiary.
or, (ii) permit the Principal Insurance Subsidiary to (a) merge or consolidate, unless the surviving corporation meets the requirements of the following paragraph; or (b) convey, transfer, lease or sell its properties and assets substantially as an entirety to any Person, except to an entity that meets the requirements of the following paragraph.
Notwithstanding the foregoing, the Principal Insurance Subsidiary may be merged into or consolidated with another insurance company or health maintenance organization organized under the laws of the United States of America, any province or state thereof, the Commonwealth of Puerto Rico or the District of Columbia if, after giving effect to such merger or consolidation, the Company or any wholly owned Subsidiary owns at least 80% of the voting stock of such other insurance company or health maintenance organization then issued and outstanding free and clear of any Lien and if, immediately after giving effect thereto and treating any such resulting institution thereafter as the Principal Insurance Subsidiary and as a Subsidiary for purposes of this Agreement, no Default has occurred and is continuing.
11.5. LIMITATION ON DIVIDENDS AND OTHER PAYMENT RESTRICTIONS AFFECTING SUBSIDIARIES.
Create or otherwise cause or permit to exist or become effective, or
permit any of its Subsidiaries to create or otherwise cause or permit to exist
or become effective, any consensual encumbrance or restriction on the ability of
any Subsidiary to (i) pay dividends or make any other distribution on its
capital stock, (ii) make any loans or advances to the Company, or (iii) transfer
any of its property or assets to the Company, to the extent such encumbrance or
restriction materially affects the ability of the Company to comply with all its
material obligations, including its obligations hereunder. The foregoing
limitations shall not apply to encumbrances or restrictions existing under or by
reason of (a) any encumbrances or restrictions pursuant to an agreement in
effect on the date of this Agreement, (b) any restrictions, with respect to a
Person that is not a Subsidiary on the date of this Agreement, under any
agreement in existence at the time such Person becomes a Subsidiary (unless such
agreement was entered into in connection with, or in contemplation of, such
Person becoming a Subsidiary on or after the date of this Agreement), (c) any
restrictions existing under any agreement that amends, refinances or replaces
the agreement containing restrictions described in the foregoing clauses (a) and
(b) and this clause (c), provided that the terms and conditions of any such
restrictions, taken as a whole, are not materially less favorable to the Holders
of the Notes than those under the agreement so amended, refinanced or replaced,
(d) customary non-assignment or sublease provisions of any lease governing a
leasehold interest of any Subsidiary, (e) those imposed by
applicable law or regulation, (f) those imposed by an agreement with a regulatory authority, and (g) any restrictions with respect to a Subsidiary imposed pursuant to an agreement which has been entered into for the sale or disposition of all or substantially all of the Capital Stock or assets of such Subsidiary. This Section 11.5 shall not apply as long as the Notes are rated in one of the four highest rating categories by any nationally recognized statistical rating organization.
11.6. LIMITATION ON ADDITIONAL INDEBTEDNESS.
Incur or permit any of its Subsidiaries to incur or become liable with respect to any Indebtedness for Borrowed Money, unless after giving pro forma effect to the incurrence of such indebtedness and the application of the proceeds thereof the Consolidated Debt Service Coverage Ratio of the Company shall be equal to or greater than 1.25 to 1.00. For purposes hereof, the Consolidated Debt Service Coverage Ratio, as of any date of determination, means the ratio of (1) net income for the most recent four fiscal quarters for which financial statements have been made available to the Holders, plus interest expense, depreciation and amortization for such period, to the extent deducted from revenues in calculating net income, to (2) principal and interest payable with respect to Indebtedness for Borrowed Money, all calculated on a consolidated basis for the Company and its Subsidiaries in accordance with GAAP. This Section 11.6 shall not apply as long as the Notes are rated in one of the four highest rating categories by any nationally recognized statistical rating organization.
11.7. WAIVER OF CERTAIN COVENANTS.
The Company may omit in any particular instance to comply with any term, provision or condition set forth in Sections 10.5, 11.3, 11.4, 11.5 and 11.6 hereof, if before the time for such compliance, the Majority Holders shall by act of such holders, either waive such compliance in such instance or generally waive compliance with such term, provision or condition, but no such waiver shall extend to or affect such term, provision or condition except to the extent expressly so waived, and, until such waiver shall become effective, the obligations of the Company in respect of such term, provision or condition shall remain in full force and effect.
12. EVENTS OF DEFAULT.
An "EVENT OF DEFAULT" shall exist if any of the following conditions or events shall occur and be continuing:
(a) failure to pay interest on the Notes for more than five (5) days after the payment is due; or
(b) failure to pay principal or premium, if any, on any Note when due, whether at maturity, upon redemption, by declaration of acceleration or otherwise; or
(c) any breach of Section 11.1 hereof, which breach remains unremedied for thirty (30) days; or
(d) any breach of Section 11.2, 11.3, 11.4, 11.5 or 11.6 hereof; or
(e) failure by the Company or any Significant Subsidiary to observe or perform in any material respect any other covenant contained herein for thirty (30) days after the Majority Holders give written notice to the Company thereof; or
(f) the Company or any Significant Subsidiary shall default in the
payment of any principal or interest due (regardless of
amount) under any Indebtedness for Borrowed Money in an
aggregate principal amount in excess of Five Million United
States Dollars (US$5,000,000), which default shall have
resulted in such Indebtedness for Borrowed Money becoming or
being declared due and payable prior to the date on which it
would otherwise have become due and payable, without such
acceleration having been rescinded or annulled within thirty
(30) days after written notice of such default shall have been
given to the Company or such Significant Subsidiary, as the
case may be, requesting such acceleration to be rescinded or
annulled and stating the such notice is a "notice of default"
hereunder; provided, that if such default shall be cured by
the Company or such Significant Subsidiary or waived by the
holders of such Indebtedness for Borrowed Money, the Event of
Default hereunder by reason thereof shall likewise be deemed
to have been cured without any action on the part of any of
the holders; or
(g) any judgment or decree for the payment of money in excess of Five Million United States Dollars (US$5,000,000) shall be rendered against the Company or any Significant Subsidiary and shall not be fully covered by insurance, and there is a period of sixty (60) days following such judgment during which such judgment or decree is not discharged, waived, or the execution thereof stayed; or
(h) the entry of a decree or order by a court having jurisdiction in the premises adjudging the Company or any Significant Subsidiary a bankrupt or insolvent, or approving as properly filed a petition seeking reorganization, arrangement, adjustment or composition of or in respect of the Company or any Significant Subsidiary under any applicable United States federal, state or provincial bankruptcy, insolvency, reorganization or other similar law, or appointing a receiver, liquidator, assignee, trustee, sequestrator or other similar official of the Company or any Significant Subsidiary or of any substantial part of its property or ordering the winding up or liquidation of its affairs, and the continuance of any such decree or order unstayed and in effect for a period of ninety (90) consecutive days; or
(i) the institution by the Company or any Significant Subsidiary of proceedings to be adjudicated a bankrupt or insolvent, or the consent by it to the institution of bankruptcy or insolvency proceedings against it, or the filing by it of a petition or answer or consent seeking reorganization or relief under any applicable United States federal, state or provincial bankruptcy, insolvency, reorganization or other similar law, or the consent
by it to the filing of any such petition or to the appointment of a receiver, liquidator, assignee, trustee, sequestrator or other similar official of the Company or any Significant Subsidiary or of any substantial part of its property, or the making by the Company or any Significant Subsidiary of a general assignment for the benefit of creditors, or the admission by it in writing of its inability to pay its debts generally as they become due and its willingness to be adjudicated a bankrupt, or the taking of corporate action by the Company or any Significant Subsidiary in furtherance of any such action.
13. REMEDIES ON DEFAULT, ETC.
13.1. ACCELERATION.
(a) If an Event of Default with respect to the Company described in paragraph (h) or (i) of Section 12 has occurred, all the Notes then outstanding shall automatically become immediately due and payable.
(b) If any other Event of Default has occurred and is continuing, the Majority Holders may, at their option, by notice given to the Company as provided for herein, declare all the Notes to be immediately due and payable.
Upon any Notes becoming due and payable under this Section 13.1, whether automatically or by declaration, such Notes will forthwith mature and the entire unpaid principal amount of such Notes, plus all accrued and unpaid interest thereon (to the full extent permitted by applicable law), shall all be immediately due and payable, in each and every case without presentment, demand, protest or further notice, all of which are hereby waived.
13.2. OTHER REMEDIES.
If any Default or Event of Default has occurred and is continuing, and irrespective of whether any Notes have become or have been declared immediately due and payable under Section 13.1, you may proceed to protect and enforce your rights by an action at law, suit in equity or other appropriate proceeding, whether for the specific performance of any agreement contained herein or in the Notes, or for an injunction against a violation of any of the terms hereof or thereof, or in aid of the exercise of any power granted hereby or thereby or by law or otherwise.
13.3. RESCISSION.
At any time after any Notes have been declared due and payable pursuant to clause (a) or (b) of Section 13.1, by written notice to the Company, the Majority Holders may rescind and annul any such declaration and its consequences if (i) the Company has paid all overdue interest on the Notes, all principal of the Notes that are due and payable and are unpaid other than by reason of such declaration, and all interest on such overdue principal and (to the extent permitted by applicable law) any overdue interest in respect of the Notes, at the Default Rate, (ii) all Events of Default and Defaults, other than non-payment of amounts that have become due solely by reason of such declaration, have been cured or have been waived pursuant
to Section 17, and (iii) no judgment or decree has been entered for the payment of any monies due pursuant hereto to the holders of the Notes. No rescission and annulment under this Section 13.3 will extend to or affect any subsequent Event of Default or Default or impair any right consequent thereon.
13.4. NO WAIVERS OR ELECTION OF REMEDIES, EXPENSES, ETC.
No course of dealing and no delay in exercising any right, power or
remedy shall operate as a waiver thereof or otherwise prejudice the holder's
rights, powers or remedies. No right, power or remedy conferred by this
Agreement or by the Notes shall be exclusive of any other right, power or remedy
referred to herein or therein or now or hereafter available at law, in equity,
by statute or otherwise. Without limiting the obligations of the Company under
Section 15, the Company will pay on demand such further amount as shall be
sufficient to cover all reasonable out-of-pocket costs and expenses incurred in
any enforcement or collection under this Section 13, including, without
limitation, reasonable attorneys' fees, expenses and disbursements.
14. REGISTRATION; EXCHANGE; SUBSTITUTION OF NOTES.
14.1. REGISTRATION OF NOTES.
The Company shall keep at its principal executive office a register for the registration and registration of transfers of the Notes. The name and address of each holder of one or more Notes, each transfer thereof and the name and address of each transferee of one or more Notes shall be registered in such register. Prior to due presentment for registration of transfer, the Person in whose name any Note shall be registered shall be deemed and treated as the owner and holder thereof for all purposes hereof, and the Company shall not be affected by any notice or knowledge to the contrary. If and as applicable, the Company shall give to any holder of a Note that is an Institutional Investor, promptly upon request therefor, a complete and correct copy of the names and addresses of all registered holders of Notes.
14.2. TRANSFER AND EXCHANGE OF NOTES.
Upon surrender of any Note at the principal executive office of the Company for registration of transfer or exchange (and in the case of a surrender for registration of transfer, duly endorsed or accompanied by a written instrument of transfer duly executed by the registered holder of such Note or his attorney duly authorized in writing and accompanied by the address for notices of each transferee of such Note or part thereof), the Company shall execute and deliver, at the Company's expense (except as provided below), one or more new Notes (as requested by the holder thereof) in exchange therefor, in an aggregate principal amount equal to the unpaid principal amount of the surrendered Note. Each such new Note shall be payable to such Person as such holder may request and shall be substantially in the form of Exhibit 1. Each such new Note shall be dated and bear interest from the date to which interest shall have been paid on the surrendered Note or dated the date of the surrendered Note if no interest shall have been paid thereon. The Company may require payment of a sum sufficient to cover any stamp tax or governmental charge imposed in respect of any such transfer of Notes. Notes shall not be transferred in denominations of less than One Million United States Dollars (US$1,000,000),
provided that if necessary to enable the registration of transfer by a holder of its entire holding of Notes, one Note may be in a denomination of less than One Million United States Dollars (US$1,000,000). Any transferee, by its acceptance of a Note registered in its name (or the name of its nominee), shall be deemed to have made the representations set forth in Sections 6.1, 6.2 and 6.3.
14.3. REPLACEMENT OF NOTES.
Upon receipt by the Company of evidence reasonably satisfactory to it of the ownership of and the loss, theft, destruction or mutilation of any Note (which evidence shall be, in the case of an Institutional Investor which is the registered holder, notice from such Institutional Investor of such ownership and such loss, theft, destruction or mutilation), and
(a) in the case of loss, theft or destruction, of indemnity reasonably satisfactory to it (provided that if the holder of such Note is, or is a nominee for, the Purchasers or an Institutional Investor with a minimum net worth of at least One Hundred Million United States Dollars (US$100,000,000), such Person's own unsecured agreement of indemnity shall be deemed to be satisfactory), or
(b) in the case of mutilation, upon surrender and cancellation thereof,
the Company at its own expense shall execute and deliver, in lieu thereof, a new Note, dated and bearing interest from the date to which interest shall have been paid on such lost, stolen, destroyed or mutilated Note or dated the date of such lost, stolen, destroyed or mutilated Note if no interest shall have been paid thereon.
15. PAYMENTS ON NOTES.
15.1. PLACE OF PAYMENT.
Subject to Section 15.2, payments of principal becoming due and payable on the Notes shall be made in San Juan, Puerto Rico at the principal office of the Company in such jurisdiction. The Company may at any time, by notice to each holder of a Note, change the place of payment of the Notes so long as such place of payment shall be either a principal office of the Company in Puerto Rico or a principal office of a bank or trust company in Puerto Rico. Interest shall be payable by check mailed to the registered holders of the Notes at their address set forth in the registration books held by the Company or, in the case of holders of at least One Million United States Dollars (US$1,000,000) in aggregate principal amount, by wire transfer to the account set forth in such registration books.
15.2. HOME OFFICE PAYMENT.
So long as you or your nominee shall be the holder of any Note, and notwithstanding anything contained in Section 15.1 or in such Note to the contrary, the Company will pay all sums becoming due on such Note for principal, and interest by the method and at the address specified for such purpose below your name in Schedule A, or by such other method or at such other address as you shall have from time to time specified to the Company in writing for
such purpose, without the presentation or surrender of such Note or the making
of any notation thereon, except that upon written request of the Company made
concurrently with or reasonably promptly after payment or redemption in full of
any Note, you shall surrender such Note for cancellation, reasonably promptly
after any such request, to the Company at its principal executive office or at
the place of payment most recently designated by the Company pursuant to Section
15.1. Prior to any sale or other disposition of any Note held by you or your
nominee you will, at your election, either endorse thereon the amount of
principal paid thereon and the last date to which interest has been paid thereon
or surrender such Note to the Company in exchange for a new Note or Notes
pursuant to Section 14.2. The Company will afford the benefits of this Section
15.2 to any Institutional Investor that is the direct or indirect transferee of
any Note purchased by you under this Agreement and that has made the same
agreement relating to such Note as you have made in this Section 15.2.
16. SURVIVAL OF REPRESENTATIONS AND WARRANTIES; ENTIRE AGREEMENT.
The representations and warranties contained in Section 5 hereof shall survive the execution and delivery of this Agreement, the Notes and the purchase by you of any Note or portion thereof or interest therein, regardless of any investigation made at any time by or on behalf of you. Such representations and warranties are not for the benefit of any subsequent holder of the Notes. All statements contained in any certificate or other instrument delivered by or on behalf of the Company to the Purchasers pursuant to this Agreement shall be deemed representations and warranties of the Company under this Agreement. Subject to the preceding sentence, this Agreement and the Notes embody the entire agreement and understanding between you and the Company and supersede all prior agreements and understandings relating to the subject matter hereof.
17. AMENDMENT AND WAIVER.
17.1. REQUIREMENTS.
This Agreement and the Notes may be amended, and the observance of
any term hereof or of the Notes may be waived (either retroactively or
prospectively), with (and only with) the written consent of the Majority Holders
and the Company, except that (a) no amendment or waiver of any of the provisions
of Sections 1, 2, 3, 4, 5 or 6 hereof, or any defined term (as it is used
therein), will be effective as to you unless consented to by you in writing, and
(b) no such amendment or waiver may, without the written consent of the holder
of each Note at the time outstanding affected thereby, (i) subject to the
provisions of Section 13 relating to acceleration or rescission, change the
amount or time of any redemption or payment of principal of, or reduce the rate
or change the time of payment or method of computation of interest on, the
Notes, (ii) change the percentage of the principal amount of the Notes the
holders of which are required to consent to any such amendment or waiver, or
(iii) amend any of Sections 8, 12(a), 12(b), 13, 17 or 20 hereof.
17.2. SOLICITATION OF HOLDERS OF NOTES.
(a) Solicitation. The Company will provide each holder of the Notes (irrespective of the amount of Notes then owned by it) with the same information provided to any other holders with respect to any proposed amendment, waiver or consent in respect of any of the provisions hereof or of the Notes. The Company will deliver executed or true and correct copies of each amendment, waiver or consent effected pursuant to the provisions of this Section 17 to each holder of outstanding Notes promptly following the date on which it is executed and delivered by, or receives the consent or approval of, the requisite holders of Notes.
(b) Payment. The Company will not directly or indirectly pay or cause to be paid any remuneration, whether by way of supplemental or additional interest, fee or otherwise, or grant any security, to any holder of Notes as consideration for or as an inducement to the entering into by any holder of Notes or any waiver or amendment of any of the terms and provisions hereof or of the Notes, unless such remuneration is concurrently offered (and paid if accepted) or paid, or security is concurrently offered (and granted if accepted) or granted, on the same terms, ratably to each holder of Notes then outstanding even if such holder did not consent to such waiver or amendment.
17.3. BINDING EFFECT, ETC.
Any amendment or waiver consented to as provided in this Section 17 applies equally to all holders of Notes and is binding upon them and upon each future holder of any Note and upon the Company without regard to whether such Note has been marked to indicate such amendment or waiver. No such amendment or waiver will extend to or affect any obligation, covenant, agreement, Default or Event of Default not expressly amended or waived or impair any right consequent thereon. No course of dealing between the Company and the holder of any Note and no delay in exercising any rights hereunder or under any Note shall operate as a waiver of any rights of any holder of such Note.
17.4. NOTES HELD BY COMPANY, ETC.
Solely for the purpose of determining whether the holders of the requisite percentage of the aggregate principal amount of Notes then outstanding approved or consented to any amendment, waiver or consent to be given under this Agreement or the Notes, or have directed the taking of any action provided herein or in the Notes to be taken upon the direction of the holders of a specified percentage of the aggregate principal amount of Notes then outstanding, Notes directly or indirectly owned by the Company or any of its Affiliates shall be deemed not to be outstanding.
17.5. CONSENT OF MAJORITY HOLDERS.
Whenever consent of the holders of Notes is required by this Agreement, the Company will request the consent of such holders through written notice to each holder of
record. The Company may engage the services of a third party in order to assist the Company to obtain consent of said holders of the Notes.
18. NOTICES.
All notices and communications provided for hereunder shall be in writing and sent either by (a) telecopy if the sender on the same day sends a confirming copy of such notice by a recognized overnight delivery service (charges prepaid), (b) registered or certified mail with return receipt requested (postage prepaid), or (c) a recognized overnight delivery service (with charges prepaid). Any such notice must be sent:
(a) if to you or your nominee, to you or it at the address specified for such communications in Schedule A, or at such other address as you or it shall have specified to the Company in writing,
(b) if to any other holder of any Note, to such holder at such address as such other holder shall have specified to the Company in writing, or
(c) if to the Company, to the Company at 1441 F. D. Roosevelt
Avenue, Sixth Floor, San Juan, Puerto Rico 00920, Attention:
Chief Financial Officer, or at such other address as the
Company shall have specified to the holder of each Note in
writing.
Notices under this Section 18 will be deemed given only when actually received.
19. REPRODUCTION OF DOCUMENTS.
This Agreement and all documents relating thereto, including, without limitation, (a) consents, waivers and modifications that may hereafter be executed, (b) documents received by you at the Closing (except the Notes themselves), and (c) financial statements, certificates and other information previously or hereafter furnished to you, may be reproduced by you by any photographic, photostatic, microfilm, microcard, miniature photographic or other similar process and you may destroy any original document so reproduced. The Company agrees and stipulates that, to the extent permitted by applicable law, any such reproduction shall be admissible in evidence as the original itself in any judicial or administrative proceeding (whether or not the original is in existence and whether or not such reproduction was made by you in the regular course of business) and any enlargement, facsimile or further reproduction of such reproduction shall likewise be admissible in evidence. This Section 19 shall not prohibit the Company or any other holder of Notes from contesting any such reproduction to the same extent that it could contest the original, or from introducing evidence to demonstrate the inaccuracy of any such reproduction.
20. CONFIDENTIAL INFORMATION.
For the purposes of this Section 20, "CONFIDENTIAL INFORMATION" means information delivered to you by or on behalf of the Company or any of its Affiliates in connection with the transactions contemplated by or otherwise pursuant to this Agreement that is clearly marked or labeled or otherwise adequately identified when received by you as being confidential
information of the Company or such Affiliate, provided that such term does not include information that (a) was publicly known or otherwise known to you prior to the time of such disclosure, (b) subsequently becomes publicly known through no act or omission by you or any person acting on your behalf or (c) otherwise becomes known to you other than through disclosure by or on behalf of the Company or any of its Affiliates or as a result of a breach of a confidentiality agreement (which breach is known to you). You will maintain the confidentiality of such Confidential Information and will not disclose it to other Persons and (except in connection with your holding of Notes and exercise of rights under the Notes or this Agreement) will not use it, provided that you may deliver or disclose Confidential Information to (i) your directors, officers, employees, agents, attorneys and affiliates (to the extent such disclosure reasonably relates to the administration of the investment represented by your Notes and provided such recipients are advised of the confidential nature of such information), (ii) your financial advisors and other professional advisors (to the extent such disclosure reasonably relates to your investment in the Notes) who agree to hold confidential the Confidential Information substantially in accordance with the terms of this Section 20, (iii) any other holder (unless known by you to be a competitor of the Company) of any Note, (iv) any Institutional Investor (unless known by you to be a competitor of the Company) to which you sell or offer to sell such Note or any part thereof or any participation therein (if such Person has agreed in writing prior to its receipt of such Confidential Information to be bound by the provisions of this Section 20), (v) any Person (unless known by you to be a competitor of the Company) from which you offer to purchase any security of the Company (if such Person has agreed in writing prior to its receipt of such Confidential Information to be bound by the provisions of this Section 20), (vi) as may be required by any federal or state regulatory authority having jurisdiction over you, (vii) as may be required by any nationally recognized rating agency that requires access to information about your investment portfolio, or (viii) any other Person to which such delivery or disclosure may be necessary (w) to effect compliance with any law, rule, regulation or order applicable to you, (x) in response to any subpoena or other legal process, (y) in connection with any litigation to which you are a party or (z) if an Event of Default has occurred and is continuing, to the extent you may reasonably determine such delivery and disclosure to be necessary in the enforcement or for the protection of the rights and remedies under your Notes and this Agreement. Each holder of a Note, by its acceptance of a Note, will be deemed to have agreed to be bound by and to be entitled to the benefits of this Section 20 as though it were a party to this Agreement. Without limiting the foregoing, on reasonable request by the Company in connection with the delivery to any holder of a Note of information required to be delivered to such holder under this Agreement or requested by such holder under this Agreement, such holder will enter into a separate agreement with the Company embodying and confirming the provisions of this Section 20.
21. MISCELLANEOUS.
21.1. SUCCESSORS AND ASSIGNS.
All covenants and other agreements contained in this Agreement by or on behalf of any of the parties hereto bind and inure to the benefit of their respective successors and assigns (including, without limitation, any subsequent holder of a Note) whether so expressed or not.
21.2. PAYMENTS DUE ON NON-BUSINESS DAYS.
Anything in this Agreement or the Notes to the contrary notwithstanding, any payment of principal of or interest on any Note that is due on a date other than a Business Day shall be made on the next succeeding Business Day without including the additional days elapsed in the computation of the interest payable on such next succeeding Business Day.
21.3. SEVERABILITY.
Any provision of this Agreement that is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall (to the full extent permitted by law) not invalidate or render unenforceable such provision in any other jurisdiction.
21.4. CONSTRUCTION.
Each covenant contained herein shall be construed (absent express provision to the contrary) as being independent of each other covenant contained herein, so that compliance with any one covenant shall not (absent such an express contrary provision) be deemed to excuse compliance with any other covenant. Where any provision herein refers to action to be taken by any Person, which action such Person is prohibited from taking, such provision shall be applicable whether such action is taken by such Person or on such Person's behalf. Titles and headings of the sections of this Agreement appear as a matter of convenience only and shall not affect the construction hereof. The words "HEREIN," "HEREOF," "HEREUNDER" and "HERETO" refer to this Agreement as a whole. The term "INCLUDING" means "INCLUDING WITHOUT LIMITATION" whether or not so expressed. All currencies used herein are U.S. dollars.
21.5. COUNTERPARTS.
This Agreement may be executed in any number of counterparts, each of which shall be deemed an original but all of which together shall constitute one instrument. Each counterpart may consist of a number of copies hereof, each signed by less than all, but together signed by all, of the parties hereto.
21.6. GOVERNING LAW.
This Agreement shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the law of the Commonwealth of Puerto Rico without giving effect to any principles of conflicts of law which might make the laws of any other jurisdiction applicable.
* * * * *
If you are in agreement with the foregoing, please so indicate by signing the acceptance on the accompanying counterpart of this Agreement and return it to the Company, whereupon this Agreement shall become a binding agreement among you and the Company.
Very truly yours,
TRIPLE - S MANAGEMENT CORPORATION
/s/ ___________________________________ Juan Jose Roman, CPA Vice President of Finance and Chief Financial Officer |
The foregoing is hereby agreed
to as of the date thereof:
First Puerto Rico Tax-Exempt Target Maturity Fund II, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund III, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund IV, Inc.
First Puerto Rico Tax-Exempt Target Maturity Fund V, Inc.
First Puerto Rico Tax-Exempt Fund, Inc.
First Puerto Rico Tax-Advantaged Target Maturity Fund II, Inc.
First Puerto Rico Income Opportunities Target Maturity Fund II, Inc.
First Puerto Rico AAA Target Maturity Fund I, Inc.
First Puerto Rico AAA Target Maturity Fund II, Inc.
First Puerto Rico Equity Opportunities Fund, Inc.
First Puerto Rico Growth and Income Fund, Inc.
By: /s/ ____________________________________________________ Name: Juan C. Batlle Title: Senior Vice President |
SCHEDULE A
INFORMATION RELATING TO PURCHASERS
Principal Amount of Name and Address of Purchasers Notes to be Purchased ------------------------------ --------------------- First Puerto Rico Tax-Exempt Target Maturity Fund II, Inc. $ 1,800,000.00 First Puerto Rico Tax-Exempt Target Maturity Fund III, Inc. $ 2,000,000.00 First Puerto Rico Tax-Exempt Target Maturity Fund IV, Inc. $ 1,000,000.00 First Puerto Rico Tax-Exempt Target Maturity Fund V, Inc. $ 2,500,000.00 First Puerto Rico Tax-Exempt Fund, Inc. $ 2,500,000.00 First Puerto Rico Tax-Advantaged Target Maturity Fund II, Inc. $ 7,000,000.00 First Puerto Rico Income Opportunities Target Maturity Fund II, Inc. $ 32,950,000.00 First Puerto Rico AAA Target Maturity Fund I, Inc. $ 3,500,000.00 First Puerto Rico AAA Target Maturity Fund II, Inc. $ 4,500,000.00 First Puerto Rico Equity Opportunities Fund, Inc. $ 1,250,000.00 First Puerto Rico Growth and Income Fund, Inc. $ 1,000,000.00 |
All payments by wire transfer of immediately available funds to:
Citibank, N.A.
ABA 021000089
For further credit to each Purchaser's DDA account specified below:
1.) First Puerto Rico Tax-Exempt Target Maturity Fund II, Inc. DDA acct 36200856
2.) First Puerto Rico Tax-Exempt Target Maturity Fund III, Inc. DDA acct 36203168
3.) First Puerto Rico Tax-Exempt Target Maturity Fund IV, Inc. DDA acct 36205649
4.) First Puerto Rico Tax-Exempt Target Maturity Fund V, Inc. DDA acct 36206748
5.) First Puerto Rico Tax-Exempt Fund, Inc. DDA acct 36207513
6.) First Puerto Rico Tax-Advantaged Target Maturity Fund II, Inc. DDA acct 36240858
Schedule A
7.) First Puerto Rico Target Maturity Income Opportunities Fund II, Inc. DDA acct 36245085
8.) First Puerto Rico AAA Target Maturity Fund I, Inc DDA acct 36242386
9.) First Puerto Rico AAA Target Maturity Fund II, Inc. DDA acct 36243717
10.) First Puerto Rico Equities Opportunities Fund, Inc. DDA acct 36203504
11.) First Puerto Rico Growth and Income, Inc. DDA acct 36780643
with sufficient information to identify the source and application of such funds.
All notices of payments and written confirmations of such wire transfers
Santander Asset Management
Suite 900, 221 Ponce de Leon Ave
Hato Rey, Puerto Rico 00917-1825
Att: Frank Serra Operations Vice-President
(3) All other communications:
Santander Asset Management
Suite 900, 221 Ponce de Leon Ave
Hato Rey, Puerto Rico 00917-1825
Att: Frank Serra Operations Vice-President
Telephone 787-759-5342
Telefax 787-296-5435
(4) Notes are to be delivered to:
Santander Asset Management Corporation, as investment advisor for the
Purchasers
Schedule A
SCHEDULE B
DEFINED TERMS
As used herein, the following terms have the respective meanings set forth below or set forth in the section hereof following such term:
"AFFILIATE" means, at any time, and with respect to any Person, any other Person that at such time directly or indirectly through one or more intermediaries Controls, or is Controlled by, or is under common Control with, such first Person. Unless the context otherwise clearly requires, any reference to an "AFFILIATE" is a reference to an Affiliate of the Company.
"ANTI-MONEY LAUNDERING LAWS" means all applicable laws, rules, regulations and other requirements relating to applicable anti-money laundering rules, including the USA Patriot Act of 2001 (the "PATRIOT ACT"), the regulations administered by the U.S. Department of Treasury's Office of Foreign Assets Control thereunder and other applicable U.S. and non-U.S. anti-money laundering laws, statutes, regulations and internal rules in connection therewith.
"BUSINESS DAY" means any day other than a Saturday, a Sunday or a day on which commercial banks in San Juan, Puerto Rico are required or authorized to be closed.
"CLOSING" is defined in Section 3.
"CODE" means the Internal Revenue Code of 1986 and the rules and regulations promulgated thereunder as in effect on the Closing.
"COMPANY" means Triple-S Management Corporation, a Puerto Rico corporation.
"CONFIDENTIAL INFORMATION" is defined in Section 20.
"CONTROL" (and the correlative terms thereof) means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a Person, whether through the ownership of voting securities, by contract or otherwise.
"DEFAULT" means an event or condition the occurrence or existence of which would, with the lapse of time or the giving of notice or both, become an Event of Default.
"DEFAULT RATE" means that rate of interest that is the greater of (i) two percent (2%) per annum above the rate of interest stated in clause (a) of the first paragraph of the Notes or (ii) two percent (2%) over the rate of interest publicly announced from time to time by Citibank, N.A. in New York City as its "BASE" or "PRIME" rate for U.S. dollar commercial loans.
"ENVIRONMENTAL LAWS" means any and all federal, state, local, and foreign statutes, laws, regulations, ordinances, rules, judgments, orders, decrees, permits, concessions, grants, franchises, licenses, agreements or governmental restrictions relating to pollution and the
protection of the environment or the release of any materials into the environment, including but not limited to those related to hazardous substances or wastes, air emissions and discharges to waste or public systems.
"ERISA" means the Employee Retirement Income Security Act of 1974, as amended from time to time, and the rules and regulations promulgated thereunder from time to time in effect.
"ERISA AFFILIATE" means any trade or business (whether or not incorporated) that is treated as a single employer together with the Company under section 210 of ERISA.
"EVENT OF DEFAULT" is defined in Section 12.
"EXCHANGE ACT" is defined in Section 7.1(a).
"GAAP" means generally accepted accounting principles as in effect from time to time in the United States of America.
"GOVERNMENTAL AUTHORITY" means
(a) the government of
(i) the United States of America, the Commonwealth of Puerto Rico or any State of the United States or other political subdivision thereof, or
(ii) any jurisdiction in which the Company or any of its Subsidiaries conducts all or any part of its business, or which asserts jurisdiction over any properties of the Company or any of its Subsidiaries, or
(b) any entity exercising executive, legislative, judicial, regulatory or administrative functions of, or pertaining to, any such government.
"GROUP MEMBER" shall mean the Company and each of its Subsidiaries.
"HOLDER" means, with respect to any Note, the Person in whose name such Note is registered in the register maintained by the Company pursuant to Section 14.1.
"INDEBTEDNESS FOR BORROWED MONEY" means any obligation (whether present or future or secured or unsecured) for the payment or repayment of money borrowed or raised (whether or not for a cash consideration), by whatever means (including deposits and financial leasing or under or pursuant to any letter of credit (once such letter of credit shall have been drawn upon) to secure financial accommodation, promissory note, certificate of deposit or like instrument (whether negotiable or otherwise) or any acceptance credit facility, note purchase facility or bill acceptance or discounting facility or like arrangement entered into) by any Person in order to enable it to finance its operations or capital requirements; it being acknowledged that reimbursement obligations in respect of advance payments made by or on behalf of third party
customers in relation to purchase orders to the Company are not "INDEBTEDNESS
FOR BORROWED MONEY."
"INSTITUTIONAL INVESTOR" means (a) any original purchaser of a Note and
(b) any bank, trust company, savings and loan association or other financial
institution, any pension plan, any investment company, any insurance company,
any broker or dealer, trust, corporation, partnership or any other similar
financial institution or entity, regardless of legal form that is an "accredited
investor" as defined in Rule 501(a) under the Securities Act; provided, however,
that any investment company licensed under the laws of the Commonwealth of
Puerto Rico and exempt from registration under the Investment Company Act of
1940 which otherwise meets the criteria of an "accredited investor" under Rule
501(a), shall qualify as an "INSTITUTIONAL INVESTOR".
"LIEN" means any mortgage, pledge, lien, hypothecation, prior claim, security interest or other charge or encumbrance and any deferred purchase, sale-and-purchase or sale-and-leaseback arrangement and any other arrangement of a like or similar effect.
"MAJORITY HOLDERS" means the holders of Notes representing in the aggregate a majority in aggregate outstanding principal amount of the Notes.
"MATERIAL" means, with respect to any Person, material in relation to the business, operations or condition (financial or otherwise) of such Person and its Subsidiaries taken as a whole; provided that for purposes of this Agreement, any amount or obligation shall be deemed to be "material" if it equals or exceeds 10% of the Company's consolidated stockholder's equity, as set forth in the most recent annual or quarterly financial statements of the Company filed with the SEC or otherwise delivered to the holders of the Notes.
"MATERIAL ADVERSE EFFECT" means a material adverse effect on (a) the business, operations or condition (financial or otherwise) of the Company and its Subsidiaries taken as a whole, or (b) the ability of the Company to perform its obligations under this Agreement or the Notes, or (c) the validity or enforceability against the Company of this Agreement or the Notes.
"MULTIEMPLOYER PLAN" means any Plan that is a "MULTIEMPLOYER PLAN" (as such term is defined in section 4001(a)(3) of ERISA).
"NOTES" is defined in Section 1.
"OFFICER'S CERTIFICATE" means, with respect to any Person, a certificate of a Senior Financial Officer or of any other officer of such Person whose responsibilities extend to the subject matter of such certificate.
"OPINION OF COUNSEL" means a written opinion of counsel from legal counsel who is acceptable to the Majority Holders. The counsel may be an employee of, or external counsel to the Company.
"PERSON" means an individual, partnership, corporation, limited liability company, association, trust, unincorporated organization or a government or agency or political subdivision thereof.
"PLAN" means an "EMPLOYEE BENEFIT PLAN" (as defined in section 3(3) of ERISA) that is or, within the preceding five years, has been established or maintained, or to which contributions are or, within the preceding five years, have been made or required to be made, by the Company or any ERISA Affiliate or with respect to which the Company or any ERISA Affiliate may have any liability.
"PRINCIPAL INSURANCE SUBSIDIARY" means Triple-S, Inc. and its successors and assigns.
"PRIRC" means the Puerto Rico Internal Revenue Code of 1994, as amended.
"PROPERTY" or "PROPERTIES" means, unless otherwise specifically limited, real or personal property of any kind, tangible or intangible, choate or inchoate.
"PRUSA" is defined in Section 6.1(a).
"PURCHASERS" means the Persons named as such in Schedule A of this Agreement.
"QPAM EXEMPTION" means Prohibited Transaction Class Exemption 84-14 issued by the United States Department of Labor.
"REDEMPTION DATE" is defined in Section 9.1.
"RESPONSIBLE OFFICER" means any Senior Financial Officer and any other officer of the Company with responsibility for the administration of the relevant portion of this agreement.
"RISK-BASED CAPITAL RATIO" ("RBC") means the Risk-based capital ratio of the Company computed in accordance with the formula promulgated by the National Association of Insurance Commissioners to measure the amount of capital required from time to time to support the consolidated business operations of holding companies principally engaged in the business of the Company, considering, among others, the size of its assets, risk profile and reserve items.
"SEC" is defined in Section 7.1(a).
"SECURITIES ACT" means the Securities Act of 1933, as amended from time to time.
"SENIOR FINANCIAL OFFICER" means the chief financial officer, principal accounting officer, treasurer or comptroller of any Person.
"SIGNIFICANT SUBSIDIARY" means any Subsidiary (including its Subsidiaries) of the Company which (1) is principally engaged in (a) the healthcare and medical insurance business as an insurance company or a health maintenance organization, (b) the property and casualty insurance business, or (c) the life insurance business, and (2) meets any of the following conditions: (i) the Company's and its other Subsidiaries' investments in and advances to the Subsidiary exceed 20 percent of the total assets of the Company and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; (ii) the Company's and its other Subsidiaries' proportionate share of the total assets (after intercompany eliminations) of the Subsidiary exceeds 20 percent of the total assets of the Company and its Subsidiaries consolidated
as of the end of the most recently completed fiscal year; or (iii) the Company's and its other Subsidiaries' equity in the income from continuing operations before income taxes, extraordinary items and cumulative effect of a change in accounting principles of the Subsidiary exceeds 20 percent of such income of the Company and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; provided, however, that for purposes of paragraphs (h) and (i) of Section 12 hereof, the term "SIGNIFICANT SUBSIDIARY" shall mean any Subsidiary of the Company which generates gross revenues in an amount that exceeds 20 percent of the consolidated gross revenues of the Company and its Subsidiaries consolidated as of the end of the most recently completed fiscal year.
"SUBSIDIARY" means with respect to any Person, any other Person more than fifty percent of whose stock or other equity interest of any class or classes having by the terms thereof ordinary voting power to elect a majority of the directors (or equivalent officials) of such other Person (irrespective of whether or not at the time stock or other equity interests of any class or classes of such other Person shall have or might have voting power by reason of the happening of any contingency) is at the time owned by such Person, directly or indirectly through Subsidiaries. Unless the context otherwise clearly requires, any reference to a "SUBSIDIARY" is a reference to a Subsidiary of the Company.
"TREASURY" means the Puerto Rico Treasury Department.
"WHOLLY OWNED SUBSIDIARY" means a Subsidiary of which all of the outstanding voting stock (other than directors' qualifying shares) is at the time, directly or indirectly, owned by the Company, or by one or more wholly owned Subsidiaries of the Company or by the Company and one or more wholly owned Subsidiaries of the Company.
SCHEDULE 5.3
Financial Statements of the Company
Audited Consolidated Financial Statements for the Company for the fiscal year ended on December 31, 2004 and Non-Audited Consolidated Financial Statements for the Company for the quarter ended on September 30, 2005.
Sch 5.3 -1
SCHEDULE 5.6
Litigation
(i) Drs. Carlyle Benavent and Ibrahim Perez (the plaintiffs) caused the initiation of an administrative proceeding before the Puerto Rico Commissioner of Insurance (the "Commissioner") against the Company and Triple-S, Inc. ("TSI"), one of its wholly owned subsidiaries, alleging the illegality of the repurchase and subsequent sale of 1,582 shares of TSI's common stock due to the fact that the ultimate purchasers of said shares were selected on an improper and selective basis by the Company in violation of the Puerto Rico Insurance Code. The plaintiffs alleged that they were illegally excluded from participation in the sale of shares by TSI due to the illegally selective nature of the sale of shares and that, consequently the sale of shares should be eliminated.
On December 1996, the Commissioner issued an order to annul the sale of the 1,582 shares that TSI had repurchased from the estate of deceased stockholders. TSI contested such orders through an administrative and judicial review process. Consequently, the sale of 1,582 shares was cancelled and the purchase price was returned to each former stockholder. In the year 2000, the Commissioner issued a pronouncement providing further clarification of the content and effect of the order. This order also required that all corporate decisions undertaken by TSI through the vote of its stockholders of record, be ratified in a stockholders' meeting or in a subsequent referendum. In November 2000, the Company, as the sole stockholder of TSI, ratified all such decisions. Furthermore, on November 19, 2000, the Company held a special stockholders' meeting, where a ratification of these decisions was undertaken except for the resolution related to the approval of the reorganization of TSI and its subsidiaries. This resolution did not reach the two thirds majority required by the order because the number of shares that were present and represented at the meeting was below such amount (total shares present and represented in the stockholders' meeting was 64%). As stipulated in the order, the Company began the process to conduct a referendum among its stockholders in order to ratify such resolution. The process was later suspended because upon further review of the scope of the order, the Commissioner issued an opinion in a letter dated January 8, 2002 which indicated that the ratification of the corporate reorganization was not required.
In another letter dated March 14, 2002, the Commissioner stated that the ratification of the corporate reorganization was not required and that TSI had complied with the Commissioner's order of December 6, 1996 related to the corporate reorganization. Thereafter, the plaintiffs filed a petition for review of the Commissioner's determination before the Puerto Rico Circuit Court of Appeals. Such petition was opposed by TSI and by the Commissioner.
Pursuant to that review, on September 24, 2002, the Puerto Rico Circuit Court of Appeals issued an order requiring the Commissioner to order a meeting of stockholders to ratify TSI's corporate reorganization and the change of name of TSI from Seguros de Servicio de Salud de Puerto Rico, Inc. to Triple-S, Inc. The Puerto Rico Circuit Court of Appeals
Sch 5.6 -1
based its decision on administrative and procedural issues directed at the Commissioner. The Commissioner filed a motion of reconsideration with the Puerto Rico Circuit Court of Appeals on October 11, 2002. TSI and the Company also filed a motion of reconsideration.
On October 25, 2002, the Puerto Rico Circuit Court of Appeals dismissed the Commissioner's Motion for Reconsideration and ordered the plaintiffs to reply to TSI's and the Company's Motion of Reconsideration.
On May 18, 2003, the Puerto Rico Circuit Court of Appeals granted TSI's and the Company's Motion of Reconsideration. The Puerto Rico Circuit Court of Appeals held that the Commissioner had the authority to waive the celebration of a referendum to ratify TSI's reorganization and that therefore the reorganization of TSI, inasmuch as the 1,582 shares annulled were not decisive, was approved by the stockholders.
On June 26, 2003, the two stockholders presented a writ of certiorari before the Supreme Court of Puerto Rico. TSI and the Company filed a motion opposing the issuance of the writ. The writ was issued by the Supreme Court on August 22, 2003, when it ordered the Puerto Rico Circuit Court of Appeals to transmit the record of the case. On December 1, 2003, the plaintiffs filed a motion submitting their case on the basis of their original petition. TSI and the Company filed its brief on December 30, 2003, while the Commissioner, in turn, filed a separate brief on December 31, 2003. On June 24, 2004 the Supreme Court ordered the plaintiffs to file a brief in support of their allegations. The case is still pending before the Supreme Court of Puerto Rico. It is the opinion of management that the corporate reorganization as approved is in full force and effect.
(ii) On September 4, 2003, Jose Sanchez and others filed a putative class action complaint against the Company, present and former directors of the Company and TSI, and others, in the United States District Court for the District of Puerto Rico, alleging violations under the Racketeer Influenced and Corrupt Organizations Act, better known as the RICO Act. The suit, among other allegations, alleges a scheme to defraud the plaintiffs by acquiring control of TSI through illegally capitalizing TSI and later converting it to a for-profit corporation and depriving the stockholders of their ownership rights. The plaintiffs base their later allegations on the supposed decisions of TSI's board of directors and stockholders, allegedly made in 1979, to operate with certain restrictions in order to turn TSI into a charitable corporation, basically forever. On March 4, 2005 the Court issued an Opinion and Order. In this Opinion and Order, of the twelve counts included in the complaint, eight counts were dismissed for failing to assert an actionable injury; six of them for lack of standing and two for failing to plead with sufficient particularity in compliance with the Rules. All shareholder allegations, including those described above, were dismissed in the Opinion and Order. The remaining four counts were found standing, in a limited way, in the Opinion and Order. Finally, the Court ordered that by March 24, 2005 one of the counts left standing be replead to conform to the Rules and that by March 28, 2005 a proposed schedule for discovery and other submissions be filed. The count was amended and accepted by the Court, the discovery schedule was submitted. The parties just finished class certification discovery. On
Sch 5.6 -2
November 30, 2005, Plaintiffs filed their briefs in support of their request for class certification. Defendants filed their opposition on December 14, 2005. This case is still pending before the United States District Court for the District of Puerto Rico.
(iii) On April 24, 2002, Octavio Jordan, Agripino Lugo, Ramon Vidal, and others filed a suit against the Company, TSI and others in the Court of First Instance for San Juan, Superior Section, alleging, among other things, violations by the defendants of provisions of the Puerto Rico Insurance Code, practices, unfair business practices and damages in the amount of $12.0 million. They also requested that the Company sell shares to them. After a preliminary review of the complaint, it appears that many of the allegations brought by the plaintiffs have been resolved in favor of the Company and TSI in previous cases brought by the same plaintiffs in the United States District Court for the District of Puerto Rico and by most of the plaintiffs in the local courts. The defendants, including the Company and TSI answered the complaint, filed a counterclaim and filed several motions to dismiss this claim. On February 18, 2005 the plaintiffs informed their intention to amend the complaint and the Court granted then 45 days to do so and 90 days to defendants to file the corresponding motion to dismiss. On May 9, 2005 the plaintiffs filed the amended complaint and defendants are preparing the corresponding motions to dismiss this amended complaint. The plaintiffs amended the complaint to allege similar causes of action dismissed by the United States District Court for the District of Puerto Rico in the Sanchez case. Defendants moved to dismiss the amended complaint. Plaintiffs have notified their opposition to some of the defendants' motions to dismiss. Defendants will reply once the oppositions to all of the defendant's motions are notified.
(iv) On May 22, 2003 a putative class action suit was filed by Kenneth A. Thomas, M.D. and Michael Kutell, M.D., on behalf of themselves and all other similarly situated and the Connecticut State Medical Society against the Blue Cross and Blue Shield Association ("BCBSA") and multiple other insurance companies, including TSI. The case is pending before the United States District Court for the Southern District of Florida, Miami District.
The individual plaintiffs bring this action on behalf of themselves and a class of similarly situated physicians seeking redress for alleged illegal acts of the defendants which they allege have resulted in a loss of their property and a detriment to their business, and for declaratory and injunctive relief to end those practices and prevent further losses. Plaintiffs alleged that the defendants, on their own and as part of a common scheme, systematically deny, delay and diminish the payments due to doctors so that they are not paid in a timely manner for the covered, medically necessary services they render.
The class action complaint alleges that the health care plans are the agents of BCBSA licensed entities, and as such have committed the acts alleged above and acted within the scope of their agency, with the consent, permission, authorization and knowledge of the others, and in furtherance of both their interest and the interests of other defendants.
Management believes that TSI was brought to this litigation for the sole reason of being associated with BCBSA. However, on June 18, 2004, the plaintiffs moved to amend the
Sch 5.6 -3
complaint to include the Colegio de Medicos Cirujanos de Puerto Rico (a compulsory association grouping all physicians in Puerto Rico), Marissel Velazquez, M.D., President of Colegio de Medicos y Cirujanos de Puerto Rico, and Andres Melendez, M.D., as plaintiffs against TSI. Later, Marissel Velazquez, M.D. voluntarily dismissed her complaint against TSI.
TSI, along with the other defendants, moved to dismiss the complaint under multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.
(v) On December 8, 2003 a putative class action was filed by Jeffrey Solomon, M.D., and Orlando Armstrong, M.D., on behalf of themselves and all other similarly situated and the American Podiatric Medical Association, Florida Chiropractic Association, California Podiatric Medical Association, Florida Podiatric Medical Association, Texas Podiatric Medical Association, and Independent Chiropractic Physicians, against BCBSA and multiple other insurance companies, including TSI, all members of BCBSA. The case is still pending before the United States District Court for the Southern District of Florida, Miami District.
The individual plaintiffs bring this action on behalf of themselves and a class of similarly situated physicians seeking redress for alleged illegal acts of the defendants which are alleged to have resulted in a loss of plaintiff's property and a detriment to their business, and for declaratory and injunctive relief to end those practices and prevent further losses. Plaintiffs alleged that the defendants, on their own and as part of a common scheme, systematically deny, delay and diminish the payment due to the doctors so that they are not paid in a timely manner for the covered, medically necessary services they render.
The class action complaint alleges that the health care plans are the agents of BCBSA licensed entities, and as such have committed the acts alleged above and acted within the scope of their agency, with the consent, permission, authorization and knowledge of the others, and in furtherance of both their interest and the interests of other defendants.
On June 25, 2004, the plaintiffs amended the complaint but the allegations against TSI did not vary. TSI, along with the other defendants, moved to dismiss the complaint under multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act. Management believes that TSI was made a party to this litigation for the sole reason that TSI is associated with BCBSA. TSI, along with the other defendants, moved to dismiss the complaint under multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.
Sch 5.6 -4
SCHEDULE 5.8
Liens
The Company's real properties located at 1441 F.D. Roosevelt Avenue in San Juan, Puerto Rico and 1510 F.D. Roosevelt Avenue in Guaynabo, Puerto Rico are subject to a mortgage in favor of FirstBank Puerto Rico, as collateral to a credit agreement between the Company and FirstBank Puerto Rico dated as of June 29, 1999, as amended on August 30, 2001.
Sch 5.9 -1
SCHEDULE 5.13
Existing Indebtedness for Borrowed Money
TRIPLE-S MANAGEMENT CORPORATION
Principal Amount Outstanding as of Lender Description Sept. 30, 2005 ------ ----------- -------------- FirstBank Puerto Rico Secured Loan $29,500,000 FirstBank Puerto Rico Secured Note $11,500,000 Santander Family of Funds Guaranty of Triple-S, Inc. $50,000,000 6.30% Senior Unsecured Notes due September 2019 |
TRIPLE-S, INC.
Principal Amount Outstanding as of Lender Description Sept. 30, 2005 ------ ----------- -------------- Triple-S Management Corporation Surplus Note $26,000,000 Santander Family of Funds Senior Unsecured Notes $50,000,000 6.30% Senior Unsecured Notes due September 2019 |
Sch 5.13 -1
EXHIBIT 1
THIS NOTE HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND IS NOT TRANSFERABLE EXCEPT PURSUANT TO AN EXEMPTION FROM SUCH REGISTRATION AND IN ACCORDANCE WITH THE REQUIREMENTS OF THE NOTE PURCHASE AGREEMENT REFERRED TO HEREIN.
TRIPLE-S MANAGEMENT CORPORATION
6.60% SENIOR UNSECURED NOTE DUE DECEMBER 2020
No. [-] December [-], 2005 US[$__________] [ ]
FOR VALUE RECEIVED, the undersigned, TRIPLE-S MANAGEMENT CORPORATION (herein called the "COMPANY"), a corporation organized and existing under the laws of the Commonwealth of Puerto Rico, hereby promises to pay to [-], or registered assigns, the principal sum of [-] DOLLARS (US$-) on December 21, 2020, with interest (computed on the basis of a 360-day year of twelve 30-day months) (a) on the unpaid balance thereof at the rate of six and six tenths percent (6.60%) per annum from the date hereof, payable monthly in arrears, on the first (1st) day of each month, commencing on January 1, 2006, until the principal hereof shall have become due and payable; and (b) to the extent permitted by law, on any overdue payment (including any overdue prepayment) of principal and any overdue payment of interest, payable monthly as aforesaid (or, at the option of the registered holder hereof, on demand), at a rate per annum from time to time equal to the Default Rate (as defined in the Note Purchase Agreement); provided, however, that, in the event that the Company's Risk Based Capital Ratio (as defined in the Note Purchase Agreement) is less than three hundred seventy-five percent (375%) during a period of at least one year, the interest rate payable on the principal hereof on any interest payment date after the expiration of such year shall increase to six and seventy-five tenths percent (6.75%) per annum while such condition exists.
The Company may, at its option, upon notice as provided in Section 9.1 of the Note Purchase Agreement, redeem and prepay prior to maturity from time to time, all or any part of the principal hereof on or after January 1, 2011 at a price equal to one hundred percent (100%) of the amount of principal to be redeemed together with accrued and unpaid interest, if any, to the date of redemption specified by the Company (the "REDEMPTION DATE").
The Company will give the holder of this Note written notice of any
redemption under Section 9.1 of the Note Purchase Agreement not less than thirty
(30) days and not more than sixty (60) days prior to any Redemption Date.
Payments of principal with respect to this Note shall to be made in lawful money of the United States of America at the principal office of the Company in San Juan, Puerto Rico
Exh 1-1
or at such other place in Puerto Rico as the Company shall have designated by written notice to the holder of this Note as provided in the Note Purchase Agreement.
This Note is one of a series of Senior Unsecured Notes issued pursuant to
the Note Purchase Agreement, dated December 15, 2005, as from time to time
amended or as the terms thereof may be waived (the "NOTE PURCHASE AGREEMENT"),
between the Company and the Purchasers named therein and is entitled to the
benefits thereof. Each holder of this Note will be deemed, by its acceptance
hereof, (i) to have agreed to the confidentiality provisions set forth in
Section 20 of the Note Purchase Agreement and (ii) to have made the
representations set forth in Section 6 of the Note Purchase Agreement.
This Note is registered in a register kept at the principal executive office of the Company and, as provided in the Note Purchase Agreement, upon surrender of this Note for registration of transfer, duly endorsed, or accompanied by a written instrument of transfer duly executed by the registered holder hereof or such holder's attorney duly authorized in writing, a new Note for a like principal amount will be issued to, and registered in the name of, the transferee. Prior to due presentment for registration of transfer, the Company may treat the person in whose name this Note is registered as the owner hereof for the purpose of receiving payment and for all other purposes, and the Company will not be affected by any notice to the contrary.
If an Event of Default, as defined in the Note Purchase Agreement, occurs and is continuing, the principal of this Note may be declared or otherwise become due and payable in the manner, at the price and with the effect provided in the Note Purchase Agreement.
This Note shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the law of the Commonwealth of Puerto Rico without regard to any principles of conflicts of law which might apply the laws of any other jurisdiction.
TRIPLE-S MANAGEMENT CORPORATION
By: /s/ ------------------------------------- Name: Juan Jose Roman, CPA Title: Vice President of Finance and Chief Financial Officer |
Exh 1-2
EXHIBIT 2-A
Form of Opinion of Pietrantoni Mendez & Alvarez LLP
1. The Note Purchase Agreement has been duly authorized, executed and delivered by the Company and (assuming due authorization, execution and delivery thereof by the Purchasers) constitutes a valid and legally binding agreement of the Company, enforceable against the Company in accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect or by general equitable principles (regardless of whether enforcement is considered in a proceeding in equity or at law).
2. The Notes have been duly authorized by the Company for offer, sale, issuance and delivery pursuant to the Note Purchase Agreement and, when issued and delivered in the manner provided for in the Note Purchase Agreement and delivered against payment of the consideration therefor provided for in the Note Purchase Agreement, will constitute valid and legally binding obligations of the Company, enforceable against the Company in accordance with their terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect or by general equitable principles (regardless of whether enforcement is considered in a proceeding in equity or at law).
3. No filing with, or approval, authorization, consent, license, registration, qualification, order or decree of, any court or governmental authority or agency, domestic or foreign, is necessary or required for the due authorization, execution and delivery by the Company of the Note Purchase Agreement and the Notes or for the performance by the Company of the transactions contemplated in the Note Purchase Agreement, except such as have been previously made, obtained or rendered, as applicable.
Exh 2-A-1
EXHIBIT 2-B
Form of Opinion of Enrique R. Ubarri Baragano
1 The Company, and each of its Significant Subsidiaries, has been duly organized and is validly existing as a corporation under the laws of the Commonwealth of Puerto Rico and is in good standing with the Commonwealth of Puerto Rico.
2. The Company, and each of its Significant Subsidiaries, has the corporate power and authority to own and operate its property, to lease the property it operates as lessee and to conduct the business in which it is currently engaged.
3. The Note Purchase Agreement and the Notes have been duly authorized by all necessary corporate action on the part of the Company, and constitute legal, valid and binding obligations of the Company (assuming, with respect to the Note Purchase Agreement and any Notes issued to a Purchaser, the due authorization, execution and delivery of the Note Purchase Agreement by such Purchaser), enforceable against the Company in accordance with their terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies.
4. The execution, delivery and performance by the Company of the Note Purchase Agreement and the Notes do not and will not (i) in any material respect contravene, result in any breach of, constitute a default under, require the consent of any party or result in the creation of any Lien in respect of any property of the Company or any of its Subsidiaries under the articles of incorporation or by-laws of the Company or any of its Subsidiaries, or any indenture, mortgage, deed of trust, loan, purchase or credit agreement, lease or any other material agreement or instrument to which the Company or any of its Subsidiaries is bound or by which their properties may be bound or affected, (ii) contravene, result in any breach of or constitute a default under an agreement with any Governmental Authority, (iii) conflict with or result in a breach or violation of any of the terms, conditions or provisions of any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority applicable to the Company or any of its Subsidiaries, or (iv) violate any provision of any statute or other rule or regulation of any Governmental Authority applicable to the Company or any of its Subsidiaries.
5. To the best of your knowledge and information, the conduct of the respective businesses of the Company and its Subsidiaries is not in violation of any federal, state or local statute, administrative regulation or other law, which violation is likely to have a material adverse effect on the Company and its Subsidiaries, taken as a whole; and the Company and its Significant Subsidiaries have obtained all material licenses as are necessary or required for the conduct of their businesses as presently conducted.
6. To the best of your knowledge and information, except as disclosed in Schedule 5.6 of the Note Purchase Agreement, there are no actions, suits or proceedings pending or
Exh 2-B-1
threatened against or affecting the Company, any of its Subsidiaries or any of their properties, in any court or before any arbitrator or administrative agency of any kind or before or by any Governmental Authority that, if determined adversely to the Company or any of its Subsidiaries, individually or in the aggregate, would reasonably be expected to have a material adverse effect on the Company and its Subsidiaries, taken as a whole, and no order, judgment, decree or ruling, which could reasonably be expected to have such a material adverse effect, has been issued against the Company or any of its Subsidiaries by any court, arbitrator or Governmental Authority.
Exh 2-B-2
EXHIBIT 3
ELECTION FOR NO INCOME TAX WITHHOLDING
The undersigned hereby requests that no Puerto Rico income tax withholding be made on his/her/its interest payments on the Notes. The undersigned certifies that he/she/it is either:
- Individual resident of Puerto Rico or Puerto Rico corporation electing out of the income tax withholding;
- United States citizen not resident of Puerto Rico not subject to Puerto Rico income taxation;
- Individual not citizen of the United States and not resident of Puerto Rico not subject to Puerto Rico income taxation;
- Corporation or partnership organized outside Puerto Rico not engaged in trade or business in Puerto Rico not subject to Puerto Rico income taxation;
- A tax exemption entity not subject to Puerto Rico income taxation:
_________________ (specify); or
- Other: _________________ (specify)
Very truly yours,
By: _________________________________ Name:
Title:*
Company:*
Exh 3-1
(dollar amounts in thousands) | 2005 | 2004 | 2003 | 2002 | 2001 | |||||||||||||||
Gross premiums*
|
$ | 1,591,109 | $ | 1,478,125 | $ | 1,424,522 | $ | 1,387,331 | $ | 1,289,773 | ||||||||||
Claims incurred*
|
1,404,827 | 1,285,717 | 1,217,156 | 1,203,118 | 1,147,319 | |||||||||||||||
Operating expenses
|
181,703 | 171,879 | 165,149 | 148,539 | 140,830 | |||||||||||||||
Net income
|
28,433 | 45,803 | 26,229 | 48,249 | 21,715 | |||||||||||||||
Assets
|
1,137,462 | 919,657 | 834,623 | 721,892 | 655,805 | |||||||||||||||
Capital
|
308,703 | 301,433 | 254,255 | 231,664 | 186,028 | |||||||||||||||
Return on assets (ROA)
|
2.5 | % | 5.0 | % | 3.1 | % | 6.7 | % | 3.3 | % | ||||||||||
Return on equity (ROE)
|
9.2 | % | 15.2 | % | 10.3 | % | 20.8 | % | 11.7 | % | ||||||||||
Net income to premiums
|
1.8 | % | 3.1 | % | 1.8 | % | 3.5 | % | 1.7 | % | ||||||||||
Underwriting gain
to premiums
|
0.3 | % | 1.4 | % | 3.0 | % | 2.6 | % | 0.1 | % |
* Includes amounts attributable to self-funded arrangements. |
Triple-S Group annual report | | page 3 | |
Triple-S Group annual report | | page 5 | |
Triple-S Group annual report | | page 7 | |
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Triple-S Group annual report | | page 9 | | |
property&casualty | life |
|
Triple-S Group annual report
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| page 11 | |
Triple-S Group annual report
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| page 13 | |
Triple-S
Management Corporation
|
| page 15 | |
Triple-S Group annual report
|
| page 17 | |
> | Leading health insurance company in Puerto Rico. | |
> | Provides health insurance to 1.2 million people through group plans, direct individual plans and the Puerto Rico Government Health Reform. | |
> | Underwriting income increased 5.9% in a stagnant employment market. | |
> | Launched several new products under the Medicare Advantage program, among them, Medicare Óptimo and Medicare Selecto (for Health Reform patients), and planned the launching of FarmaMed (Part D). | |
> | For the third consecutive year, it continued to be the plan with the highest satisfaction rating among health plans held by federal employees in Puerto Rico and the United States. | |
> | Retention rates among health plan group contracts rose to 97%. | |
> | Continues to be one of the most efficient health plan companies in the United States. Ninety cents of every premium dollar go to pay for direct benefits to its health plan members, while only 10 cents of every dollar are used to operate the business. | |
> | It is the leading health plan for small businesses on the Island. |
> | Manages the Health Reform for Triple-S, Inc., which has the largest number of insured under this government-sponsored program. | |
> | Qualified to market and manage the new Medicare Platino throughout Puerto Rico for people who are eligible under Medicaid and Medicare Advantage programs. This is an additional product that will contribute to the Groups diversification strategy. | |
> | Jointly operates with McKesson a health information phone line operated by nursing personnel for Triple-S, Inc. This popular service operates under the name Teleconsulta. | |
> | Also in a joint venture with McKesson, it provides these services to other companies in Puerto Rico and to 14 other U.S. customers in several states. | |
> | Actively cooperated with the Commission in studying the healthcare system in Puerto Rico, recommending improvements for the current health system. | |
> | Will apply for the accreditation of the National Committee for Quality Assurance (NCQA) in 2007, since it has achieved a compliance of 79% with its national standards. |
> | Retained its leadership in the group life insurance market in Puerto Rico. | |
> | Will merge with the Groups latest acquisition, GA Life, which holds a leadership position in the individual life insurance market. The merger will create a strong leadership position in the life insurance market. |
> | Record year for underwriting income and net income. | |
> | Contributed 35% to the Corporations net income, advancing the diversification strategy of Triple-S Group. | |
> | Experienced improvements in the loss ratio of its portfolio for the fifth consecutive year. | |
> | Confirmed its leadership in the sale of commercial package insurance in Puerto Rico. | |
> | Continued to be the primary insurance company for mortgages generated by financial institutions. | |
> | Entered second year of its Protégete program, an innovative effort to educate the consumer on minimizing damages during hurricanes and earthquakes. | |
> | Launched a new insurance policy for small businesses. | |
> | Designed ¡Seguro que sí! , a program to promote quality service within the company. | |
> | Extended its claims processing services to Caguas and Plaza Carolina. |
> | Operates one of the largest and more complex technological infrastructure centers in Puerto Rico and the Caribbean. | |
> | Processed a total of 22 million claims in 2005 for Triple-S, Inc. | |
> | It is the leading health claims processing business with 8,000 processing terminals in the offices of providers and participants. | |
> | Supported with technological solutions the launching of several new products under the Medicare Advantage program. | |
> | Provides technological solutions to Triple-S Group. |
> | It is the third largest general insurance agency in Puerto Rico. | |
> | The agency now becomes the key marketing and distribution channel for property and casualty and life insurance products for Triple-S Group. In so doing, it moves forward the Groups diversification strategy. | |
> | Began to sell Seguros Triple-S policies at the Centro de Servicio de Triple-S (Triple-S Service Center) in Plaza Las Américas. | |
> | Launched De Seguro publication for insurance brokers and agents. | |
> | Opened an office in Caguas. |
Triple-S
Management Corporation
|
| page 21 | |
EXHIBIT 14.1
CODE OF BUSINESS CONDUCT AND ETHICS
1. LEGAL COMPLIANCE
All employees, officers, and directors of Triple-S Management Corporation and those of its subsidiaries, ("the Corporation") should respect and comply with all laws, rules, and regulations of the Commonwealth of Puerto Rico as well as those of the Federal, state and municipal jurisdictions.
Such legal compliance should include, without limitation, strict observance with the "insider trading" prohibiting transactions made based on confidential or non-public information from or about the Company. This restriction involves revealing or sharing said information with others. Corporate employees, officers, and directors are encouraged to seek information at the Triple-S Management Corporation's Corporate Affairs Office if they have any question regarding the application of the aforesaid prohibition.
This Code of Business Conduct and Ethics does not summarize all the laws, rules and regulations applicable to the Corporation and its employees, officers, and directors. If any question arises or for additional information, please consult with the Corporate Affairs Office (or Legal Compliance Office) and the various guidelines, which the Corporation has prepared on specific laws, rules and regulations.
2. CONFLICTS OF INTEREST
All employees, officers, and directors of the Corporation must be scrupulous in avoiding a conflict of interests in regard to the Corporation's interests. A "conflict of interest" exists whenever an individual's private interests interfere or diverge in any way (or even appear to interfere or diverge) with those of the Corporation. A conflictive situation can arise when employees, officers, or directors undertake some action or have interests that affect the objective and effective performance of their duties in the Corporation. Another possible conflict could emerge upon an employee, officer, or director, or some member of their family, receiving improper personal benefits as a result of their position in the Corporation, whether the benefit is received from the Corporation or from a third party.
Loans to, or guarantees of obligations of, employees, officers, and directors, and their respective family members could possibly create a conflict of interest. Federal law prohibits loans to directors and executive officers. Conflicts of interest are prohibited as a matter of corporate policy.
Code of Business Conduct and Ethics
Such conflicts may not always be clear-cut; therefore, any question should be consulted with the highest managerial levels or with the Corporate Affairs Office, where the legal compliance office is ascribed. Any employee, officer, or director that notices a conflict or a potential conflict should inform a supervisor, manager, or consult the procedures described in this code.
3. CORPORATE OPPORTUNITY
Employees, officers, and directors are prohibited from:
a) Making personal use of opportunities that in truth belong to the Corporation, or which are discovered through corporate property, information, or position;
b) Using corporate property, information or position for personal benefit;
c) Competing with the Corporation.
Employees, officers, and directors are under the obligation to promote the Corporation's legitimate interests when the opportunity to do so arises.
4. CONFIDENTIALITY
Employees, officers, and directors should not disclose confidential information entrusted to them by the Corporation, its suppliers, clients, or any other person, except when disclosure is authorized by the Legal Compliance Office or required by law, regulations or legal proceedings. If an employee, officer, or director understands there is a legal obligation to disclose such information, they must consult with the Legal Compliance Office. Confidential information includes all non-public information which could be strategically useful to the Corporation's competition, or harmful to the Corporation or its clients if it were divulged.
5. FAIR DEALING
Every employee, officer, and director should endeavor to deal fairly with the Corporation's clients, suppliers, competitors, officers and directors in a fair manner. No one should take unfair advantage of any of the above-mentioned through manipulation, cover-up, concealment, the abuse of privileged information, fraudulent representation of material facts, or any other unfair business practice.
6. PROTECTION AND PROPER USE OF THE CORPORATION'S ASSETS
All employees, officers, and directors must protect the Corporation's assets and ensure their efficient use. Theft, carelessness, waste and alterations, all have a
Code of Business Conduct and Ethic
direct impact on the Corporation's assets. All of the Corporation's assets must be used for legitimate business purposes.
7. ACCOUNTING COMPLAINTS
It is corporate policy to comply with all rules and regulations regarding financial and accounting reports that apply to the Corporation. If any of the Corporation's employees, officers, and directors have any concerns or complaints regarding questionable Corporate accounting or auditing practices, the person should submit those concerns or complaints (anonymously or confidentially if desired) to the Audit Committee of the Board of Directors or any member of the Committee.
8. INFORMING OF ANY ILLEGAL OR UNETHICAL BEHAVIOR
Employees are encouraged to speak to their supervisor, manager or other appropriate officer regarding any illegal or unethical behavior observed or upon questions about the best course of action to follow regarding a particular situation whose legal or ethical nature is unclear. Employees, officers, and directors concerned about violations to this Code or that other illegal or unethical conducts have occurred or may occur should contact their supervisors or superiors. If informing the supervisors or superiors about their concerns or complaints is an inappropriate or uncomfortable option, they may contact the Legal Compliance Office, the Nomination and Compensation Committee, the Audit Committee, or the Triple-S Management Corporation's Board of Directors. If the concerns or complaints require confidentiality, including maintaining the informant's identity anonymous, this confidentiality will be protected, subject to applicable laws, regulations and/or legal proceedings that apply.
All of the Corporation's legal advisors should inform the Corporate Affairs Office and the Audit Committee regarding any violation to the Securities and Exchange Commission Regulations. Any other lack of compliance with fiduciary obligations or other similar obligations to the Corporation or its agents should be informed to the Vice-President of Legal Affairs in the Corporate Affairs Office. If he/she does not act upon the evidence presented (adopting, as necessary, the corresponding preventive measures or sanctions), the legal advisor could present said evidence to the Main Executive Officer or to the Corporation's Board of Directors' Audit Committee.
The Corporation will not allow any retaliation from or on behalf of the Corporation or its employees, officers, and directors because of reports or complaints, made in good faith, of violations to this Code or of any other unethical or illegal behavior.
Code of Business Conduct and Ethics
9. REPORT FROM LISTED CORPORATIONS
As a Corporation listed in the Securities and Exchange Commission (SEC), it is important that reports submitted to the SEC be accurate and on time. Depending on their position with the Corporation, employees, officers, and directors may be called upon to provide necessary information in order to ensure that the Corporation's public reports are complete, fair, and understandable. The Corporation expects its employees, officers, and directors to take this responsibility very seriously, providing correct and rapid responses to questions regarding the Corporation's public disclosure requirements.
10. AMENDMENTS, MODIFICATIONS AND WAIVER
This Code may be amended, modified or suspended by the Board of Directors, who can also grant suspensions or waivers, subject to disclosure and other provisions of the Securities and Exchange Act of 1934, its rules, and the rules that apply to the New York Stock Exchange.
EXHIBIT 31.1
CERTIFICATION
I, Ramon M. Ruiz-Comas, certify that:
1. I have reviewed this annual report on Form 10-K of Triple-S Management Corporation;
2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4. The registrant's other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) for the registrant and have:
a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
b) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
c) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's fourth fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and
5. The registrant's other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):
a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and
b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.
Date: March 30, 2006 By: /s/ Ramon M. Ruiz-Comas ----------------- ----------------------------------- Ramon M. Ruiz-Comas President and Chief Executive Officer |
EXHIBIT 31.2
CERTIFICATION
I, Juan J. Roman, certify that:
1. I have reviewed this annual report on Form 10-K of Triple-S Management Corporation;
2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4. The registrant's other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) for the registrant and have:
a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
b) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
c) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's fourth fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and
5. The registrant's other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):
a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and
b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.
Date: March 30, 2006 By: /s/ Juan J. Roman ------------------- ----------------------------------- Juan J. Roman Vice President of Finance and Chief Financial Officer |
EXHIBIT 32.1
CERTIFICATION
I, Ramon M. Ruiz-Comas, President and Chief Executive Officer of Triple-S Management Corporation (the Corporation), certify, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, 18 U.S.C. Section 1350, that:
1. The Annual Report on Form 10-K of the Corporation for the annual period ended December 31, 2005 (the Report) fully complies with the requirements of Section 13(a) of the Securities and Exchange Act of 1934 (15 U.S.C. 78m) and;
2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Corporation.
Date: March 30, 2006 By: /s/ Ramon M. Ruiz-Comas ------------------------- Ramon M. Ruiz-Comas President and Chief Executive Officer |
EXHIBIT 32.2
CERTIFICATION
I, Juan J. Roman, Vice President of Finance and Chief Financial Officer of Triple-S Management Corporation (the Corporation), certify, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, 18 U.S.C. Section 1350, that:
1. The Annual Report on Form 10-K of the Corporation for the annual period ended December 31, 2005 (the Report) fully complies with the requirements of Section 13(a) of the Securities and Exchange Act of 1934 (15 U.S.C. 78m) and;
2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Corporation.
Date: March 30, 2006 By: /s/ Juan J. Roman ----------------------------- Juan J. Roman Vice President of Finance and Chief Financial Officer |